Re-examining the ‘reliability’ of forensic pathology evidence

This chapter considers how forensic pathology sits within the general domain of medical science and operates according to its own professional standards, regulatory mechanisms and cultural norms, which intersect with legal processes in distinctive ways. Having reviewed the discipline’s current institutional structure in England and Wales, and highlighted certain structural risks arising from these institutional arrangements, ‘critical trust’ is advocated as the best standard for regulating reliance on forensic pathology expert evidence and assessing its probative value. Pathologists draw on an exceptional width of disciplinary knowledge, indicating the desirability of greater professional autonomy in casework decision-making. Respect for informed professionalism is contrasted with the risks of excessive cultural deference, harking back to the days of celebrity medical witnesses personified by Sir Bernard Spilsbury. The chapter then presents two detailed ‘case studies’ of criminal appeal judgments in which forensic pathology evidence played a pivotal role. These cases exemplify in microcosm the potential for injustice when the reliability of pathology evidence is doubtful or misinterpreted. Reform options are canvassed.