Cognitive Bias in Medicolegal Death Investigation

Abstract

Cognitive bias is a popular criticism of medicolegal death investigation. However, many of these criticisms are misplaced. Some have criticized the use of history into medical diagnosis. However, this criticism ignores the fact that the practice of forensic pathology is a medical discipline; it is not a simple mechanical test. History is an integral and necessary part of medical practice, and the lack of history is more dangerous than its use. Criticisms of manner determination often reflect an incorrect understanding of what manner is and what it is properly used for. Many criticisms wrapped in the flag of cognitive bias are in fact errors in scientific orthodoxy, real scientific disagreements, issues of ignorance, and lack of competence or certification, ethical lapses, and political pressure. Solutions that address cognitive bias do not address these issues. Many of the proposed solutions have not themselves been proven to be effective. Alternatives, such as intensive peer review, might address both cognitive bias and these other issues. Any proposed interventions should themselves be able to demonstrate a sound empirical basis.