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Source: Steven Clark, PhD, Section Program Chair
The theme of this year’s Academy meeting, Celebrating the Forensic Science Family, is an opportunity to recognize the efforts “family” members have made to the disciplines represented by the various sections in the American Academy of Forensic Sciences as well as the collaborative contributions members have made to the overall application of forensic science to the betterment of society. This article highlights a few collaborative projects I have had the honor of participating in over the past twenty years. Each, for better or worse, had some impact on the practice of death investigation in the United States. It should be noted that collaboration has two common definitions: the first, to work with another person or group in order to achieve or do something; and the second, to give help to an enemy who has invaded your country during a war. The first is most common and generally preferable; however, during some face-to-face development activities, some of the collaborators surely felt (at times) like they were being asked to “give help to an enemy” who was invading their territory.
For the modern era medicolegal death investigator, the 1998 U.S. Department of Justice (DOJ) publication “National Guidelines for Death Investigation” marked the beginning of standardization for both training and certification of death investigators working for medical examiner and coroner offices. Attempts at national standardization had been attempted before; however, a couple of high-profile cases in the mid-1990s put death investigation (especially procedures) under the microscope and helped convince policy-makers to seek solutions. The “guidelines project” was conceived and supported through an unlikely collaboration between two federal agencies: the Centers for Disease Control and Prevention (CDC) and the research branch of the U.S. DOJ, the National Institute of Justice (NIJ). In 1995, these agencies jointly funded a national study to identify the procedural steps associated with performing a death scene investigation (i.e., medicolegal death investigation [MDI]).
Medicolegal death investigation, long considered a hybrid “job” within many medical examiner and coroner offices, was the focus of the NIJ/CDC study which convened three panels to develop, review, and approve research findings. Although the project verified weaknesses in the training of investigators and broad inconsistencies in the performance of tasks associated with death scene investigation, the resulting guidelines were unique in their broad application. Although the performances outlined in the guidelines focused on death “scene” investigation skills, the three multidisciplinary panels that collaborated to create the initial drafts and the hundreds for investigators who vetted the material encompassed a much broader population. This population included not only investigators working for medical examiner and coroner offices, but district attorney offices, law enforcement agencies, elected officials, county executives, and many forensic specialties supporting the medicolegal death investigation. All investigative “participants” were drawn into the project’s scope (e.g., pathology and biology, criminology, anthropology, jurisprudence, odontology, etc.), and although the guidelines were dismissed by some as “basic” and investigative “common sense,” the simplicity may have encouraged acceptance and broad implementation.
The release of the National Guidelines for Death Investigation was officially announced at the American Academy of Forensic Sciences (AAFS) meeting on February 12, 1998. Within 72 hours, the document became the most requested NIJ guidelines booklet published at the time. The NIJ’s Immediate Impact Report sited 1,506 requests in the first 72 hours after release (NIJ, 1998); this was before email dominance and most requests were made by phone or fax. In April 1998, the CBS Evening News featured the Justice Department’s release of the National Guidelines for Death Investigation as one of its top news stories. The widespread acceptance and application of the 29 guidelines detailed in the research report are a tribute to the forensic collaborators who, at times, may have felt like they were sleeping with the enemy (see definition #2 above), created a set of death scene performance tasks that were “valid” regardless of jurisdiction or participating agency.
An interesting phenomena took place shortly after the guidelines booklet was released; the booklet not only provided a step-by-step chronology of investigative tasks, it became the de facto “handbook” for training and certifying medicolegal death investigators. In 1998, the American Board of Medicolegal Death Investigators (ABMDI) was founded using the national guidelines as part of its core competency skillset for testing and certifying investigators. The College of American Pathologist (CAP) published a multi-paged article describing the research and development activities surrounding the guidelines in July of 1999 (CAP Today) which the chief Medical Examiner for the State of Virginia was quoted as saying the results were “the best investigative tool since DNA.” The ABMDI certified its first investigator on January 14, 1999, and became the second-largest forensic specialty certification board in the U.S. accredited by the Forensic Specialties Accreditation Board (FSAB, March 2005). In 2002, the ABMDI added an advanced certification designed to assess higher-level forensic knowledge, report writing, and analytical skills. Today, both The National Association of Medical Examiners (NAME) and the International Association of Coroners and Medical Examiners (IAC&ME) require ABMDI certification as a part of their office accreditation standards. The “guidelines” have been renamed “Death Investigation: A Guide for the Scene Investigator,” updated (2011) and are available only as a PDF download (hardcopy booklets are rare), and serve as an example of real collaboration, where participants put down their “agendas” and focus on “what” needs to be done at every death scene regardless of affiliation or jurisdiction.
In 2002, after the National Academies of Science Symposium on Death Investigation, members of The NAME proposed a research project that would identify and validate the “standard” performance tasks associated with the “forensic” autopsy. Although the concept may have seemed odd to the outsider (who may have “assumed” standards already existed), these forensic pathologists realized that the new federal focus on medicolegal standards would soon reveal the variability of autopsy performance across the U.S. and possibly create standards and impose them without consultation. The NAME created a working group of forensic pathologist members and notified the full membership that a new “standards committee” had been formed and directed to create performance standards for the forensic autopsy that would be endorsed by The NAME. To reassure members that no standards would be developed without broader input, a series of surveys were developed to gather feedback from members during the development process. In addition, any standards developed by the committee would require a majority vote of the membership, not just the Board of Directors. The NAME standards committee included members from both medical examiner and coroner jurisdictions and although collaboration according to definition #1 was the goal, some members of the committee and general members of the organization felt this collaboration would never succeed (see definition #2).
For three years, meeting at least twice annually in multi-day sessions of deliberation, the committee drafted a set of standards that detailed the minimum performance requirements for the “complete” or “full” forensic autopsy, regardless of jurisdiction. Even though over half of the membership participated in multiple rounds of development surveying and a final round of validation surveying (with some standards receiving over 90% agreement ratings) when the NAME Forensic Autopsy Performance Standards were completed and presented to the membership at the 2005 annual business meeting, they passed by only 17 votes. This forensic collaboration was “painful”; however, the results not only defined the forensic autopsy for NAME members, but communicated an itemized list of “expectations” to all medicolegal officers (Medical Examiner, Coroner, or Justice of the Peace) who used the forensic autopsy as a part of the medicolegal investigation.
As the autopsy standards development project was winding down, another forensic collaboration was just getting started. In 2004, the CDC was looking for more reliable methods of collecting data on the circumstances surrounding sudden unexplained infant deaths (SUID) in the U.S. Death certificate data was not always detailed enough or consistent enough to make inferences nationally for program support and statistical reporting. Although the number of unexplained infant death in the U.S. was relatively small, the overall effect of mishandling cases this sensitive were far reaching, involving multiple agencies in both the public and private sectors. The collaboration between the CDC and NIJ ten years earlier to produce the death investigation guidelines was not lost on the leadership of the Maternal and Infant Health Branch of the CDC as they planned a national effort to standardize the way infant deaths were investigated and documented. Although this collaboration initially included a multi-jurisdictional team of medicolegal death investigators, it would soon extend beyond the forensic sciences to include physicians, social workers, social scientists, hospital employees, emergency medical responders, and families who had personally experienced sudden unexplained infant death.
Between 2004 and 2005, the CDC funded a multidisciplinary team of experts to create a standardized data collection tool for field investigators (SUIDI Form) and a complete educational curriculum for training infant death investigation specialists. Most significantly (and somewhat unintentionally), during the research process they had identified twenty-five scene details that forensic pathologists had indicated were “essential to know” before conducting the autopsy and establishing cause and manner of death. This list of data elements detailed the essential information and photographic documentation scene investigators needed to gather while conducting a sudden unexplained infant death investigation (SUIDI). This list (which became known as the “SUIDI Top 25”), was added to the SUIDI Form, and is now addressed in both ADMDI basic and advanced level certifications – therefore becoming a part of the office accreditation standards for both The NAME and the IAC&ME.
To ensure national dissemination of the new SUIDI protocols, the CDC supported a multiyear (2006-2008) project to conduct five national SUIDI training academies. These “train-the-trainer” academies were designed to train five-member “state teams” in the skills and knowledge associated with SUIDI. The curriculum included 28 hours of education and hands-on training conducted by expert “practitioners” from the field of infant death investigation. Team membership included representatives from the medical examiner/coroner community, law enforcement, public health, social science, epidemiology, post-secondary education, and victim advocacy. All fifty states participated in the academies, as well as a team from Europe and one representing the Native American community. These dedicated collaborators learned to use standardized SUIDI techniques (including doll-reenactment), with the expectation to return home and train local agencies in the art and science of infant death investigation. In addition, each would serve as a state resource for agencies needing assistance in conducting SUIDI training. The success of the program is reflected in the number of individuals trained by the 260 graduates; in 2010 it was estimated that over 25,000 people had been exposed to the new investigative methods and downloads of the SUIDI form and the various training materials had exceeded 50,000 requests. In addition, the performance of a doll-reenactment during a SUIDI is now considered a “standard” by the ABMDI.
Most successful forensic collaborations have humble beginnings, typically involving a small group of like-minded practitioners working to achieve a goal (definition #1). However, there are some “collaborative” projects that started out with funding and leadership but because of individual dynamics, collaboration was seen as helping an enemy invade jurisdictional space (definition #2). Products of such collaborations rarely inspire or provide direction to any specific audience and therefore pass largely unnoticed by all audiences (i.e., this applies to “them” not “us”). The National Missing and Unidentified Persons project (today know as NamUs.gov) is one successful forensic collaboration that did not necessary start out that way.
In 1998, the NIJ funded the National Center for Forensic Science (NCFS) to convene a technical working group to research and develop a “Best Practices” document for identifying human remains. Unfortunately, in an effort to “include” every constituent organization the working group became too expansive and diverse. Many members were “secondary” to the process under investigation, with limited hands-on experience in unidentified decedent casework. The actual application of a Best Practices document would affect few members of the group directly; they attended the meetings, but there was little basis for collaboration. Progress was slow, time passed, and those who were most involved (at all levels: NIJ, NCFS, and organizational members) lost motivation and interest. NAME kept an ad hoc committee together for unidentified decedent identification, but there was little national focus on missing and unidentified persons until September 11, 2001.
The years immediately following “9/11” saw renewed interest in not only standardizing the methods used to identify human remains, but the investigating and processing of missing persons cases; specifically, the application of scientific methods of making positive identifications (i.e., fingerprints, dental, and DNA analysis). In the same timespan, worldwide use of the internet and related technologies grew significantly. Widespread internet use was everywhere and electronic “collaboration” was exploding as data-sharing sites like Napster® (1998), MySpace® (2003), and Facebook® (2004) drove people online without fear. As a result, applications moved from “mainframe” environments with limited access, to web-based environments with access requiring little technical skill and hardware available at most local office supply stores.
In late 2004, two members involved in the Best Practices workgroup began designing a “web-based” unidentified decedent reporting system (UDRS) and separate endangered missing persons reporting system (EMPRS) as a proof-of-concept. The UDRS was piloted in 2005 with members of the NAME and the IAC&ME, who entered local unidentified decedent information (physical details, photographs, circumstances, etc.) into the online system that shared their data with the world. The pilot-system was presented at the NAME’s annual meeting and the NIJ became interested in somehow integrating the UDRS system with their efforts to complete the Best Practices document and their expanding interest in helping agencies (public and private) find and identify missing persons – specifically adults. In late 2005, the NIJ re-funded the NCFS to complete the Best Practices document, adding the words “using technology” and referencing NamUs (for the first time) and UDRS in the project’s title.
Almost concurrently, the NIJ awarded the National Forensic Science and Technology Center (NFSTC) with funding to focus on missing persons issues and collaborate with the NCFS project. Most importantly, the NIJ assigned the same program manager to oversee both grants. That was not only appropriate, but in retrospect proved to be the difference between the 1998 effort and the new 2005 effort; technology aside, there was now leadership from the NIJ that could focus the efforts of both grantees and integrate the collaborative activities of both working groups (UID and Missing). Plus, the emerging success of the UDRS (the first identification of a Fulton County, Georgia case #19 had already taken place), gave both working groups something tangible to focus their activities around. As a result, the Best Practices were completed and both the missing and unidentified systems were consolidated under one NIJ award to the NFSTC (2007-2012).
The NamUs story continues at the University of North Texas and its Center for Human Identification with a dedicated staff of regional system administrators and forensic specialists working to assist both public and private users. To date, over 11 million people have visited NamUs.gov helping identify and close nearly 400 unidentified decedent cold cases and find almost 900 missing persons. Over 10,000 registered users, representing nearly every forensic specialty, use the system regularly as an investigative tool to identify the unidentified and find the missing. In addition, both The NAME and IAC&ME now require offices to enter their unidentified decedent case data into NamUs as an accreditation requirement. The collaboration that built NamUs deeply involved specialists from anthropology, criminology, digital evidence, investigation, pathology, and odontology, each representing agencies at all levels of missing and unidentified persons casework – from local (e.g., county medical examiner/coroner offices and local police agencies) to international (e.g., Interpol). Each person contributed to achieve a common goal that extended beyond their professional domains in order to help others succeed.
Since the publication of the National Academies of Science Report, Strengthening Forensic Science in the United States: A Path Forward, in 2009, there has been a good deal of motion in the forensic sciences and a movement toward more consistent and structured collaborations. Currently, the focus is on the National Institute of Standards and Technology (NIST – U.S. Department of Commerce) and the new Organization of Scientific Area Committees (OSAC) which may end up including over 400 members of the forensic science community working collaboratively to develop standards and guidelines for most major forensic specialties. In addition, the National Commission on Forensic Science (NCFS – U.S. Department of Justice) was formed in 2013 to work in partnership with NIST to “enhance the practice and improve the reliability of forensic science.” Each of these new forensic collaborations will build on the successes and failures of past efforts to create an even stronger generation of forensic educators, scientists, and practitioners.