Historical Development and Contemporary Dilemmas of a Police Surgeon

Abstract

The requirement for investigation into death has been present since the mists of time. From the process of identification of the person and determination of the cause of death the Coroner’s service that operates in England today has slowly emerged. Along the evolutionary path of death investigation the concept of Clinical Forensic Medicine became established.

The formation of the Faculty of Forensic and Legal Medicine in 2006 with the objectives of promoting the advancement of education and knowledge in forensic and legal medicine and ensuring the highest professional standards of competence and ethical integrity of it’s practitioners was initially met with enthusiastic support but growth of the membership appears to be stalling. The Police Surgeon is the main clinician working in Clinical Forensic Medicine, a role that is undertaken by generalist forensic physicians and other healthcare professionals, who manage the medical aspects of custody, assault and death.

It is now pertinent to consider whether, the development of Clinical Forensic Medicine has reached the point where it can be regarded as a clinical specialty and whether those practicing in this field are specialists. This question is central to the thesis and is answered in terms of history and a discussion of the elements of the practice of Custody
Medicine, a subset of Clinical Forensic Medicine, and a review of the mechanisms that exist to determine specialty status. There is a degree of urgency to resolve this issue because Police Surgeons are increasingly being employed by private providers of forensic medical services, who constricted by budgetary control may not be able to support the development of a specialty hierarchy. If Clinical Forensic Medicine does not develop then the Criminal Justice System risks losing the services of trained collectors and evaluator of forensic medical evidence.