Importance of Crime Scene Visits by a Forensic Medicine Expert: A Survey-Based Study.

Background This study is intended to compare the Indian system of inquests, which is conducted by nonscientific people like police and magistrate (who are compulsorily neither qualified in science nor in law), and the medical examiner system of the USA which is done by doctors specialized in forensic medicine/pathology. Aims The goal of this study was to see if bringing in a medical examiner system makes a difference in determining the cause, manner, and time of death as compared to the current system of conducting inquests and autopsies by two different agencies, namely, the police and forensic medicine experts. Material and methods In the present study, a peculiar case (in which the police were clueless and the autopsy surgeon was confused during the autopsy) was chosen for getting an expert opinion from 50 forensic medicine experts from different parts of the country in which police were not clear regarding cause, manner and time of death, but later after a crime scene visit by forensic medicine experts who had conducted the autopsy, it was clarified. Opinion regarding the cause, manner, and time since death was taken from 50 medico-legal experts in two steps. In the first step, only the autopsy finding and history obtained from police were provided and in the second step, additional information obtained from the crime scene visit by forensic medicine experts was provided. The sampling method was purposive sampling. Result In the cause of death, Cohen's Kappa coefficient was 0.30% (z-statistic = 3.87, p-value = 0.0001), indicating a significantly low agreement between the first and second steps by the experts, as their decision changed after getting the evidence of the crime scene visit. In the manner of death, Cohen's Kappa coefficient was 0.06% (z-statistic = 0.66, p-value = 0.2540) indicating a very low agreement between the first and second opinions by the experts as their decision regarding the suspected manner of death changed drastically after getting the evidence of crime scene. In the time since death, Cohen's Kappa coefficient was 0.5531% (z-statistic = 7.25, p-value = 0.0001), which also indicates significant difference. Conclusion Therefore, in this study, the usefulness of the medical examiner system in the Indian setting has been proved beyond doubt expecting drastic improvement in criminal investigation by introducing the medical examiner system in India.