The forensic pathologist's public health role

ABSTRACT

While historically some have viewed the work of medical examiners/coroners (ME/C) and death investigators as predominantly serving the criminal justice system, in fact, the act of certifying a death is—in and of itself—a public health endeavor. The purpose of the death certificate is to track how and why individuals die as a means of helping others survive. Death certificates do save lives. In addition to generating these vital statistics, which guide public health policy, ME/C also perform a public health service in a variety of other ways. For instance, autopsy pathologists report unsafe consumer products, warn of recreational hazards (e.g., the dangers of snowmobile or all-terrain vehicle use), publicize and report occupational hazards (e.g., falls and electrocution risks), identify toxic exposures (e.g., carbon monoxide from defective heating units), and evaluate the safety of medical therapies. At autopsy, ME/C perform infectious disease surveillance, diagnosing and reporting communicable diseases such as bacterial meningitis, tuberculosis, and Legionella, thereby helping to mitigate disease spread in the community. They identify and characterize emerging infectious threats, such as COVID-19. They track violent deaths, including homicides, suicides, accidents, child and domestic abuse deaths, maternal mortality, and overdose deaths—to name a few—and participate as members of death review teams that attempt to identify systemic issues and prevent further such deaths. © 2023 Elsevier Inc. All rights reserved.