Mississippi, like most U.S. states, is experiencing a forensic pathologist shortage, reported the ABA Journal.
Although autopsies are performed in a timely manner
out of necessity, reports are taking months—and in some instances years—to
finalize. For example, Carolyn Green, the coroner for Mississippi’s Lee County,
said in October that one natural death from 2016 still doesn’t have a finalized
autopsy report.
The pandemic—which also precipitated a backlog in
cases—has only exacerbated the shortage. In the last two years, forensic
pathologists across the country also have been burdened by COVID-19 deaths, a
spike in homicides and an increase in accidental drug overdoses.
With the time between the autopsy and the finalized
report stretching months or even years, both prosecutors and defense attorneys
are waiting longer than usual to bring criminal cases to trial, raising due
process concerns.
The forensic pathologist shortage has been decades in the making, building since the practice became board-certified in 1959.
Few medical school graduates choose pathology
residencies, and even fewer opt to work in forensic pathology, where the pay is
lower than in other practice areas.
There are currently 500 board-certified forensic
pathologists working full time. These pathologists are tasked with determining
the cause of death for anyone who does not die in a hospital or in hospital
cases involving homicide, according to Dr. James Gill, chief medical examiner
for the state of Connecticut. Gill is also chair of the National Association of
Medical Examiners’ board of directors and the group’s immediate-past president.
In a normal year, Gill says, the U.S. has needed
more than double the number of forensic pathologists to keep up with the number
of cases sent to their offices. Increasing cases in the past two years have
only made the problem worse.
“There have been reports of national increases in
homicides, motor vehicle deaths and drug intoxication deaths,” Gill says. “For
example, the latest numbers from the CDC show a 30% increase in drug
intoxication deaths in 2020: There were 93,000 of these deaths. Each of these
needed an autopsy.”
In Chicago, the county medical examiner’s office saw
almost triple the cases in 2020. The office typically sees about 6,000 to 6,500
cases a year; in 2020, it saw 16,049. According to spokeswoman Natalia
Derevyanny, half of those deaths were COVID-19-related. Opioid deaths increased
by 40% from the previous year, and homicides increased by 50%.
“Homicides are the most labor-intensive autopsies
that we do,” Gill says. “It can take more than a day to do an autopsy on
someone who was shot 15 times. All those wounds need to be photographed; all
those bullets need to be dissected.”
Forensic pathologists prioritize conducting
autopsies so the remains can be transferred to funeral directors. Reports are
completed when the pathologists have time, and they are further delayed when
forensic pathologists are called to testify in court.
“When you are overwhelmed with autopsies, those
can’t wait. You can’t say, ‘I’ll wait until next week.’ Those have to take a
priority,” Gill says.
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