A Perspective: Gun-Related Fatalities and Manner of Death

Abstract

Because this issue of Academic Forensic Pathology is dedicated to firearms related topics, the author was invited to provide a perspective on manner of death classification in firearms-involved deaths. This article discusses cases which are routinely encountered, as well as a selected group of more rare and more controversial cases regarding manner of death classification. The experience, knowledge, personal philosophies, and even conscious or unconscious biases of individual certifiers of death vary and can have impact on manner of death certification. Further, in many cases, there is no right or wrong answer and there is plenty of room for disagreement and debate. For these reasons, and with a goal of national consistency in manner of death classification, the author recommends that the National Association of Medical Examiners implement a task force to make recommendations as to how manner of death should be classified in specific types of firearms-related deaths. To date, some guidelines have been published but they do not carry the weight of specific and official recommendations. There must always be room for certifier discretion, but such discretion could be used in the context of a set of formal recommendations as a baseline, so that variances can be explained and manner of death certifications cannot be viewed as arbitrary and/or capricious. This article includes the author's viewpoints concerning manner of death in selected cases.