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Should police officers attend autopsies?

A medical examiner’s controversial, and reportedly incorrect, testimony in a murder trial has re-energized the long-standing argument about whether police officers should attend autopsies.

According to media reports, Noel Dean, 23 at the time, was charged with fatally shooting his wife, Shannon. Dean insisted he was innocent and that Shannon, who’d previously written suicide notes and made unsuccessful attempts, shot herself in his presence.

During an interrogation videotaped by police, Dean said Shannon held a gun to the right side of her head with the handle pointing toward the floor.

Shannon’s autopsy was done by Dr. Darshan Phatak, who had joined the medical examiner’s office in Houston after passing certifying examinations the previous year. The investigating police officer, Millard Waters, attended the procedure.

During the autopsy, Waters stressed his belief that Dean had shot Shannon and his hope that the autopsy would prove him right. He told Phatak that if the gun handle was down as Dean claimed, that evidence would support the truth of Dean’s testimony. But if the handle was pointed up, Dean was lying and therefore a murderer.

Hovering over the autopsy table, Waters pointed out marks on Shannon’s skin he thought could be muzzle imprints. The position of the imprints indicated to him that the handle had been pointed up.

Phatak agreed. He also concluded from Shannon’s blood alcohol level – a level that in my experience is rarely associated with unconsciousness – that she’d been passed out on the floor when she was shot and couldn’t have taken her own life. He ruled her death a homicide.

Dean’s first trial resulted in a hung jury. During a second trial, another medical examiner demonstrated by means of a photographic overlay of the gun muzzle that the gun handle had been pointed down as Dean said. Charges were dismissed.

The Dean case caught the attention of Radley Balko, an opinion writer for The Washington Post who focuses on the criminal justice system.

“There’s so much wrong here, it’s hard to know where to begin,” Balko wrote, and I agree. We just differ on what things are the most wrong.

Here’s what I find most wrong: If Dr. Phatak believed a man who had just seen his wife shoot herself would remember details of the event with perfect clarity and that failure to do so proved his guilt, he should have known better. If he assumed someone was unconscious based on a relatively but not remarkably high blood alcohol level, he should have known better. If he allowed himself to be spoon-fed theories by a police officer, he should have known better.

And if Phatak’s limited experience was inadequate to protect him from such errors in a potential murder case, he should have been more closely supervised – the standard for young pathologists in every major jurisdiction in which I’ve ever worked.

Balko focused on another “wrong” – the common practice of encouraging investigating officers to attend autopsies.

“This is not how you go about getting an objective, scientific autopsy report untainted by cognitive bias,” Balko wrote. “There’s a good argument to be made that police and prosecutors shouldn’t consult with medical examiners at all until after the autopsy report is completed.”

“If Waters hadn’t shared his theory that Noel Dean killed his wife,” Balko wrote, “Phatak likely would merely have noted the bullet hole, the toxicology reports and so on, and then concluded that (Shannon) died of a gunshot wound to the head.”

True enough. But that opinion doesn’t require the additional 15-plus years of schooling medical examiners have to arrive at a conclusion the average 12-year-old could reach.

Balko’s article mentions “studies showing that the more information about the crime you provide to forensic analysts, the more likely they are to erroneously implicate the suspect.”

This is also true, but to apply those studies to medical examiners ignores a major distinction between forensic pathologists, who are medical doctors, and criminalists, who are bench analysts.

Medical doctors are not purely practitioners of hard science. They are experts in gathering, correlating and applying many types of information when making diagnoses. They know it’s quite possible some of that information will be more important than any scientific test.

For example, if a Minneapolis man presents to his doctor in January complaining of fevers, sweats and belly pain, the doctor won’t even consider the correct diagnosis – malaria – unless he’s told of the patient’s recent, monthlong photo safari in Africa.

To say medical examiners should be told nothing of the history and circumstances surrounding a death is the equivalent of saying doctors shouldn’t take into consideration a patient’s history and the circumstances under which he or she became ill in order to make a diagnosis.

I’ve always asked police investigators to attend when I perform autopsies. The information they provide is often invaluable. I’ve said repeatedly that if I could have only the autopsy findings or only a description of the death scene and circumstances as the basis for a determination of manner of death, I’d be right more often if I chose the latter.

I’m not denying some police investigators peddle pet theories inadequately supported by facts or that a few try to bully medical examiners into supporting those theories.

I am saying well-trained and experienced medical examiners should be able to logically evaluate such theories, arrive at independent opinions and resist police or political pressure.

I’m not saying medical examiner opinions are always right. I’m not saying mine were.

I am saying medical examiners, as physicians, should use all available information to determine cause and manner of death. That was the vision of the founders of forensic pathology: optimize death investigations by wedding the medical knowledge of a physician and the science of a criminalist.

The system isn’t perfect, but it’s the best so far devised. I wonder if anybody really thinks some other party with a yen to solve murder mysteries – cop, lawyer, newspaper reporter or Twitter follower – could consistently do a better job.

Dr. Carol J. Huser, a forensic pathologist, served as La Plata County coroner from 2003 to 2012. She now lives in Florida and Maryland. Email her at chuser@durangoherald.com.