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2 PROFESSIONAL STANDARDS IN FORENSIC PATHOLOGY
2.1 Introduction
The General Medical Council ( GMC) is responsible for maintaining the Medical Register in the United Kingdom. First and foremost, the forensic pathologist is a doctor, bound by the principles that govern this Register. While the responsibilities of the forensic pathologist may differ somewhat from those of the majority of medical practitioners, both the Scottish Government and the College advocate the principles of good practice summarised in the GMC's publication, Good Medical Practice2. This document forms the base against which should be judged every action taken by a doctor.
The responsibilities of forensic pathologists in respect of all aspects of their work, including audit, clinical governance, quality assurance, CPD, revalidation and research are the same as those of any medically qualified clinical pathologist. However, they also have responsibilities to the criminal justice system, including the need to offer impartial evidence, the integrity of which is not compromised, and the need to present such evidence in a manner that is acceptable to others involved in the criminal justice system. The forensic pathologist is an independent and objective investigator whose primary duty is to the court and they must not act in any way that fails to acknowledge that duty.
The Scottish Government and the College share responsibility for setting the standards that underpin high quality pathology services. Forensic pathologists must ensure that the service they provide is of high quality and conducted in accordance with COPFS contracts or local service delivery agreements that demonstrates a commitment to quality, transparency and accountability. It is recognised that not all deaths occur in circumstances where all the steps in this process are required, but the absence of a step does not constitute an argument for ignoring the principles inherent within the code.
The standards set out in this code must be applied by the forensic pathologist, regardless of the party instructing that individual. All pathologists have a duty to consider and investigate explanations for a death consistent with the innocence of an accused person. Where such an explanation cannot be excluded, it must be brought to the attention of the pathologist's instructing party.
2.2 The code of practice
This code sets out what is expected of the forensic pathologist in the performance of each step in the process of investigation of a suspicious death, from the initial contact from the Procurator Fiscal/police regarding that death to the presentation in a court of evidence relating to the death. It provides a framework within which clinical audit and performance review can be carried out to assure the quality of performance of individual forensic pathologists, as well as to facilitate the collection of evidence for the revalidation process.
2.3 Mortuary facilities
It is recognised that forensic pathologists may have to perform autopsies within mortuaries where they have no formal contract of employment with the providers. Forensic pathologists should be satisfied that the mortuaries in which they work are fit for purpose and have facilities equivalent to the standards set out in Scottish Health Planning Note 20: Facilities for Mortuary and Post-mortem Room Services (Health Facilities Scotland) and the documents produced by the Health Services Advisory Committee and the Advisory Committee on Dangerous Pathogens on safe working and the prevention of infection in the mortuary and post-mortem room.
If pathologists are not satisfied with any aspect of a mortuary, they should make these concerns known to those instructing them, such as the Procurator Fiscal and police force involved.
2.4 Peer review
It is important that forensic pathologists regularly consult and discuss their cases with forensic colleagues, and all pathologists must have arrangements in place so that this can be done. The value of review by peers cannot be overstressed and will be referred to throughout this document. Forensic pathologists must not work in isolation from colleagues, either within the discipline of forensic pathology or from other clinical disciplines.
2.5 Assistance from other specialists
Practitioners must have in place adequate arrangements whereby they can consult with experts in other medical specialties who may be asked to assist or advise in appropriate cases. They will be expected to have full and easy access to departments of all other branches of pathology, including secure specimen storage, to a department of radiology and to a forensic science laboratory. They should have adequate provision of modern information technology ( IT), including Internet access.
2.6 Keeping up to date
Practitioners should have ready access to a comprehensive medical library, including appropriate journals. They have a duty to keep up to date and must be able to advise the legal authorities on the current literature.
2.7 Departure from the standards
Where pathologists become aware of an unjustifiable departure from these standards, whether by themselves or by another practitioner, that departure must be brought to the attention of the pathologist's instructing party.
2.8 Record-keeping
The maintenance of adequate records is vital and full notes must be kept of briefings and conferences, as well as of all work carried out, tests performed and results obtained. Pathologists' records should be retained in accordance with agreements with the Procurator Fiscal and material should not be destroyed without the consent of the Procurator Fiscal. In particular, records should remain available to the Procurator Fiscal even after individual pathologists have moved on.
Records must be properly indexed and archived in secure storage. There may be occasions (such as at the scene of the discovery of the body or during the autopsy) in which the pathologist may dictate notes to a tape recorder. In such circumstances, the original tapes, as well as any transcript made from them, must be retained .
When recording information gained or generated at any stage of the investigation, it is important to remember that all such material is potentially disclosable to the other parties involved in a legal action.
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