Cognitive Bias in Medicolegal Death Investigation

Abstract

Cognitive bias is a popular criticism of medicolegal death investigation. However, many of these criticisms are misplaced. Some have criticized the use of history into medical diagnosis. However, this criticism ignores the fact that the practice of forensic pathology is a medical discipline; it is not a simple mechanical test. History is an integral and necessary part of medical practice, and the lack of history is more dangerous than its use. Criticisms of manner determination often reflect an incorrect understanding of what manner is and what it is properly used for. Many criticisms wrapped in the flag of cognitive bias are in fact errors in scientific orthodoxy, real scientific disagreements, issues of ignorance, and lack of competence or certification, ethical lapses, and political pressure. Solutions that address cognitive bias do not address these issues. Many of the proposed solutions have not themselves been proven to be effective. Alternatives, such as intensive peer review, might address both cognitive bias and these other issues. Any proposed interventions should themselves be able to demonstrate a sound empirical basis.

Barriers to consistent and reliable investigation of sudden unexpected infant death: Perspectives from law enforcement

“…Cognitive bias in forensic science has become a contentious issue warranting careful consideration [39]; sources of bias in policing have also received significant attention [40]. A developing body of literature is seeking to ensure forensic science integrity, probe sources of bias, debate appropriate responses, and warn against conflation of cognitive bias with other significant structural or procedural barriers to high-quality medicolegal death investigation [36,41,42]. As scholars deliberate over challenges to the objective pursuit of science in forensic medicine, this study provides additional opportunities for discussion as well as concrete recommendations to mitigate some sources of bias during law enforcement participation in an SUID investigation.…”

Homicides Disguised as Staged Suicides

“…When investigating a death, it is important to take into consideration the scene findings, the case history, forensic evidence, and findings at forensic autopsy (6). Although reducing cognitive bias is important in all forensic science disciplines, it is important to remember that forensic pathology cannot be practiced without knowledge of surrounding investigative information (7).…”

Homicide in a Horse Barn?

“…Failure to recognize accidental (or natural) deaths, and instead consider them to be homicides, can result in wasted time and resources, false allegations, and possible life‐altering consequences. In addition, the cases serve to emphasize the fact that forensic pathology represents the practice of medicine, which requires sufficient historical information when attempting to make diagnoses . Without knowledge of circumstances related to how the body is found, or the background history, the forensic pathologist is unable to perform his/her job to the best of his/her ability.…”