Standards Forensic Pathology (007.1)

Part I. General Introduction to Standards

§ 1. Background to and aim of the Standards

Reporting forensic experts play a crucial role in the administration of justice. The NRGD aims to ensure justified confidence in forensic expertise for stakeholders. This confidence must be based on the demonstrable independently safeguarded quality of forensic investigators and their reports on the basis of (inter)national forensic-specific standards.

The NRGD is managed by the Board of Court Experts (hereinafter: Board). The Board’s core task is to rule on the applications for registration or repeat registration in the register of the NRGD (register). To that end the Board first defines the field of expertise. This is important in order to inform applicants, assessors and users of the register (e.g. judge, public prosecutor and attorney) about the activities an expert in the field of expertise in question engages in and about the activities that fall outside the field of expertise. The demarcation of the field of expertise is set out in Part II of these Standards.

The Board also determines the criteria on the basis of which an assessment is made for each field of expertise as to whether an application complies with the quality requirements. The generic requirements are set out in the Register of Court Experts in Criminal Cases Decree (Besluit register deskundige in strafzaken). These requirements are elaborated further for each field of expertise. This elaboration is set out in Part III of these Standards.

Furthermore the Board determines the assessment procedure. This procedure is described in Part IV of these Standards.

The NRGD has a system of periodic repeat registration. Court experts must demonstrate every five years that they still meet the requirements in force at that time. The Standards are dynamic and are being developed further in order to enhance the quality of the experts. These Standards set out the current state of the (sub-)field of expertise.

§ 2. Types of applicants

The NRGD distinguishes two types of applicants: the initial applicant and the repeat applicant. The initial applicant is a reporter who at the time of submission of the application is not yet registered in the register for the field of expertise to which the application relates. The repeat applicant is an expert who is already registered in the register for the field of expertise to which the application relates.

These two types of applicants are subdivided as follows:

Initial applicant:

If the assessment is favourable, the reporter without work of his own will only qualify for temporary registration.

Repeat applicant:

The initial applicant is an applicant who at the time of submission of the application does not have an NRGD registration. An initial applicant could be:

In respect of initial applicants, it is necessary to make a clear distinction between the independent reporter and the reporter without work of his own. An example of a reporter without work of his own is the newly-trained expert. This expert has completed the forensic training (reporter’s training), but has not yet been able to independently write the number of reports required for the assessment because these are written under the supervision of a tutor during the training. Another example of a reporter without work of his own is the reporter whose earlier application was rejected and who has been working (partly) under supervision following this rejection.

The Board adopts the following principle. Every applicant must draw up a List of Case Information. This list must include a specific number of cases in a period specified by the Board immediately preceding the application. If the List of Case Information includes one or more cases which have been prepared under supervision, the applicant will be qualified as a ‘reporter without work of his own’. An additional requirement applies to the applicant who was rejected earlier: the case reports included in the List of Case Information must have been drawn up after the date of the Board’s decision rejecting the earlier application (Policy Framework on Application after Rejection).1It is possible to make an exception to this general rule, namely in case of an earlier rejection pursuant to Article 12(2), sub-paragraph a, of the Register of Court Experts in Criminal Cases, the so-called training requirement. Reports written before the date of the Board’s decision rejecting the earlier application may be included in the List of Case Information, provided that they were drawn up within the generally applicable period preceding the time of submission of the new application.

The distinction between the various types of repeat applicants is important in the context of the assessment procedure: the documents a repeat applicant must submit, the composition of the Advisory Committee on Assessment and the assessment method.

§ 3. Justification of Standards

These Standards have been established by the Board in accordance with the Register of Court Experts in Criminal Cases Decree (Besluit register deskundige in strafzaken) and the Experts in Criminal Cases Act (Wet deskundige in strafzaken). Representatives from the various domains were consulted; users (judges, public prosecutors and lawyers) and subject matter experts in the field (professional organisations, representative associations, experts both at home and abroad). The draft of the Standards has also been published on the NRGD website for public consultation.

§ 4. Validity of Standards

The Standards are valid from the date shown on the cover. The validity runs until the moment of publication of a new version. In principle it will be checked annually as being up-to-date. This check can lead to a new version. The aim is to publish the new version no more than once a year.

§ 5. Version management and formal revision history

All changes made to the Standards lead to a new version. Newer versions of (parts of) the Standards are designated with a higher version number.

5.1. Version management

In the case of editorial changes the old version number is increased by 0.1. Editorial changes have no substantive impact. In the case of substantive changes the version number is increased by 1.

5.2. Formal revision history

The revision history starts with version 1.0 as the first formally approved version. Substantive changes made are briefly described in the revision history (Annex C). This makes it possible to trace which Standards are valid at any given moment at all times.

Part II. Demarcation of Forensic Pathology

§ 1. Introduction

Below, a description is given of the field of expertise of forensic pathology as defined by the NRGD and the activities forensic pathologists registered in the NRGD engage in.

§ 2. Core activities

The primary focus of the forensic pathologist is to conduct an external and internal examination on the body of a deceased person, in principle in the context of criminal law.

A forensic pathologist conducts a post-mortem examination in order to (help) answer medico-legal questions in cases of (suspected) unnatural death:2Enumerations a. through j. are derived from the Council of Europe Committee of Ministers (1999) Recommendation no. R(99)3 Of the committee of ministers to member states on the harmonisation of medico-legal autopsy rules.

The task of the forensic pathologist is:

In addition, a forensic pathologist is:

§ 3. Methodology

In order to answer the abovementioned medico-legal questions, the forensic pathologist:

A forensic pathologist is able to conduct the examination in cooperation with other experts (e.g. forensic toxicologists, forensic anthropologists, forensic odontologists, forensic geneticians etc.) and to refer to them where relevant.

§ 4. Boundaries of the field of expertise

Within the field of forensic and legal medicine, two distinct areas of practice exist:

The activities of these fields of expertise show an overlap to a certain extent, but for both fields of expertise specific knowledge and experience are needed that set experts within these fields apart from each other. In principle, the activities within the field of forensic clinical medicine fall outside of the field of forensic pathology as defined by the NRGD for registration.

The following related fields of expertise also fall outside of the field of forensic pathology as defined by the NRGD for registration:

Though the related fields of expertise fall outside of the field of forensic pathology, a registered forensic pathologist has to have knowledge of the principles of the abovementioned related fields of expertise, is able to adequately refer the commissioning party, to adequately deal with sampling in the chain of investigations and to integrate the findings in the final expert conclusion.

§ 5. Registration

The register will state the name of the relevant expert as an expert in the field of 007.1 Forensic Pathology.

Part III. Registration requirements for Forensic Pathology

The general (repeat) registration requirements are given in the next paragraphs in italics with a reference to Article 12 paragraph 2 in the Register of Court Experts in Criminal Cases Decree (Besluit register deskundige in strafzaken).

An expert will only be registered as an expert in criminal cases upon submission of the application if, in the opinion of the Board, the expert:

§ 1. Article 12(2) sub-paragraph a

(...) has sufficient knowledge and experience in the field of expertise to which the application relates.

1.1. Initial: independent reporter

¹ The medico-legal or forensic autopsy [is the type of autopsy] which is performed on the instructions of the legal authority responsible for the investigation of sudden, suspicious, obscure, unnatural, litigious or criminal deaths. This legal authority may be a coroner, a medical examiner, a procurator fiscal, a magistrate, a judge, or the police, the systems varying considerably from country to country. Saukko, P. & Knight, B., (2004). Knight’s Forensic Pathology. Hodder Arnold Publishers, 3rd edition, p. 2.

1.2. Initial: reporter without work of his own

¹ Ibid.

1.3. Repeat applicant: after unconditional registration

¹ Ibid.

1.4. Repeat applicant: after conditional registration

¹ Ibid.

§ 2. Article 12(2) sub-paragraph b

(...) has sufficient knowledge of and experience in the field of law concerned, and is sufficiently familiar with the position and the role of the expert in this field.

§ 3. Article 12(2) sub-paragraph c

(...) is able to inform the commissioning party whether, and if so, to what extent the commissioning party’s question at issue is sufficiently clear and capable of investigation in order to be able to answer it on the basis of their specific expertise.

An applicant should have:

§ 4. Article 12(2) sub-paragraph d

(...) is able, on the basis of the question at issue, to prepare and carry out an investigation plan in accordance with the applicable standards.

An applicant should:

§ 5. Article 12(2) sub-paragraph e

(...) is able to collect, document, interpret and assess investigative materials and data in a forensic context in accordance with the applicable standards.

An applicant should:

§ 6. Article 12(2) sub-paragraph f

(...) is able to apply the current investigative methods in a forensic context in accordance with the applicable standards.

An applicant should:

§ 7. Article 12(2) sub-paragraph g

(...) is able to give a verifiable and well-reasoned case report on the assignment and any other relevant aspects of their expertise in terms which are comprehensible to the commissioning party, both orally and in writing.

An applicant should:

§ 8. Article 12(2) sub-paragraph h

(...) is able to complete an assignment within the stipulated or agreed period.

§ 9. Article 12(2) sub-paragraph i

(...) is able to carry out the activities as an expert independently, impartially, conscientiously, competently, and in a trustworthy manner.

An applicant should:

§ 10. Hardship clause

The Board may decide not to apply or deviate from a registration requirement if application of such requirement would produce very unreasonable results. The hardship clause may only offer a solution in certain exceptional situations. It is up to the applicant himself to submit facts and circumstances showing that a certain registration requirement is unreasonable in his specific case.

Part IV. Assessment procedure for Forensic Pathology

§ 1. General

In all fields of expertise the assessment will be based on the written information provided, including as a minimum requirement case reports and items of evidence, supplemented in principle with an oral assessment. However, such an oral assessment will not be necessary if the applicant's expertise has already been clearly demonstrated by the written information.

The assessment will in principle be carried out on the basis of the information provided by the applicant:

If it is felt necessary in the context of the assessment an additional case report and/or information, for example information about the way collegial review and/or supervision is organized within the organization, can be requested.

§ 2. Assessment procedure per type of applicant

2.1. Initial: independent reporter

2.2. Initial: reporter without work of his own

2.3. Repeat applicant: after unconditional registration

2.4. Repeat applicant: after conditional registration

Annex A. Educational paths in Europe

Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists
Country	Forensic Medicine	Forensic pathology	Forensic pathology
Belgium	Total of 5 years ‘specialist in forensic medicine’ (master after master structure) comprises at least the following items: – 12 months theoretical instruction about medical expertises – 18 months practical instruction in the pathological anatomy – 30 months theoretical and practical instruction in forensic medicine (p. 42) During training: – 75 forensic autopsies as 1st ‘obducent’ – 150 complete external examinations – 150 forensic clinical investigations. (registratie door FOD Volksgezondheid met getuigschrift specialisatieopleiding ‘Specialist in Gerechtelijke Geneeskunde’)
Germany	At least five years: – 6 months clinical pathology – 6 months psychiatry/forensic psychiatry – 6 months in pathology/public health/pharmacology/toxicology/psychiatry – 3,5 years in forensic medicine Other regulations of the medical councils: – 400 complete external examinations of bodies with detailed description – 25 crime scene investigations – 300 forensic autopsies – 2000 histological investigations – 200 cases oral of written report for court – 10 cases stains have to be analysed – 25 forensic osteological and odontological investigations Examination: local medical council, oral exam on the basis of written reports (Registration as ‘Specialist in Forensic Medicine’, Facharzt für Rechtsmedizin)
Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists	Postgraduate training Forensic Pathologists
---	---	---	---
Country	Forensic Medicine	Forensic pathology	Forensic pathology
The Netherlands	– 5 years clinical pathology – NFI: 12-18 months on forensic elements including final exam Number of forensic autopsies: – 100 forensic autopsies in 1,5 years (MSCR- registration as ‘Patholoog’)
UK	Total of 5 years and 6 months – basic clinical pathology: Stage A (1 year) and Stage B (1-1,5 years) – forensic pathology: Stage C (2 ½ years) and Stage D (6 months) Number of forensic autopsies Stage A: 20 Stage B: 20 adult, 2 pediatric Stage C/D: 80 per year (3 ped, 3 neuro) (UK registration in the GMC List of Registered Medical Practioners with a sub speciality Histopathology (Forensic Pathology)):

References:

• –. B. Madea and P. Saukko (eds), Forensic Medicine in Europe, Schmidt-Römhild Lübeck, 2008

• –. KNMG Besluit Pathologie, 12 april 2010, Opleidingsplan NVVP november 2010 en NFI, Curriculum Inwerktraject Forensisch Patholoog

• –. The Royal College of Pathologists 2011

Voorstel voor Ministerieel besluit tot vaststelling van de bijzondere criteria voor de erkenning van artsen-specialisten, houders van de bijzonder beroepstitel in de gerechtelijke geneeskunde, evenals van stagemeesters en van stagediensten voor de opleiding in deze discipline

Annex B. NRGD glossary