Category: Forensic Studies

Medicolegal Death: A Look at Cultural, Scientific, and Ethical Principles

In the media, many see the ideals of Medicolegal Death Investigations portrayed through TV shows involving crime and justice.  While a show like Bones may inspire many to believe that the system is often clear-cut and one that ultimately brings justice, there are many principles and issues that surround the field.  Having a deeper understanding of the different elements that work in today’s medicolegal system could prove beneficial in addressing some of the controversial topics faced in our modern era.  Since the early implementation of medicolegal systems, there have been many inconsistencies and changes made.

As described by Daniel J. Spitz in Medicolegal Investigation of Death, medicine and law have been dated as far back to the Egyptian era. Medicolegal investigations have been performed by coroners since the 9th  and 10th century in England, initially presented under the reign of King Richard I.[i] Once colonists became settled, coroners, elected officials who take the responsibility to determine the cause of death within the county level.[ii]   were introduced to the colonies to help with medical needs. Coroners were replaced by medical examiners in the late 1800s, where they were identified as physicians who performed autopsies for coroners.[iii]  The first official medical examiner system was created in New York City in 1918, and gradually spread across the United States, replacing coroners. Although the idea of the medical examiner system was created, its definition varies in qualifications and training, as seen by the coroner vs. medical examiner discrepancy. After centuries of coroners used as the primary source to investigate deaths, there has been a push for medical examiners, who tend to have more skills than coroners. Medical examiners, who are trained in pathology, examine bodies to determine death and can focus either in a county, district, or state. Although medical examiners are seen as more trained and knowledgeable, the state decides to determine how it is defined.[iv] Death investigators may also assist with the investigations as well, dealing more with the legal aspects. These investigations are not controlled in a hospital setting, rather are investigated in laboratories and scenes by medical examiners and coroners.

Early depictions of coroners and their facilities.[v]

After the initial creation of the field, the medicolegal system developed and is the major contributors in the investigation of deaths of individuals and helps determine how people have died. By 1954, an act known as the Model Post-mortem Examinations Act was created to serve as a guideline for the states to create their own laws.[vi]  It was proposed to set up offices, laboratories, and those involved in criminal justice, as well an Armed Forces Medical Examiner System that helps identify remains after natural disasters. In attempt to define the medicolegal jurisdiction, the Model Post-mortem Examination Act of 1954 states that deaths that were from violence, with a potential public health threat, not by a known disease, inmates, or from occupational disease or injury, can be reported to the medical examiner and coroner.[vii] Today, the deaths medicolegal investigations specify on are still unexpected or violent death, such as homicides, suicides, unintentional injuries, drug-related deaths, and others. These deaths are investigated because of the legality and public health implications.[viii]

The development of county medical examiner systems peaked in the 1980s, but have declined immediately after, leading to the system we know today. Unlike the Uniform Determination of Death Act, there are no national death investigation laws, meaning the state determines what laws are needed, thus creating different systems for coroners and medical examiners.  The lack of doctors trained in this field makes it hard to conduct all death investigations in the United States. Not as many physicians are hired because it is a higher pay than having untrained people follow through with the death investigations.  This will be further explored later.

As a comparison of the inconsistencies between states, North Carolina has a county-based system where there are medical examiners located everywhere, and need training and experience in the field.[ix] Compared to Michigan, each county has a physician medical examiner, meaning they have more training and are licensed. New Mexico has only one office, known as the Office of the Chief Medical Investigator [OCMI], where all medicolegal death investigations are conducted.  While inconsistencies exist, most medicolegal investigations occur in similar manners.

The process of medicolegal investigation is as follows. After the incident has occurred, the policeman arrives to see what happened and the ambulance arrives. The policeman is in charge of calling the medical examiner’s office to speak with the death investigator and is assigned the case, where the investigator will observe the scene. After taking notes about the scene and position of the body or surroundings, the investigator interrogates witnesses and takes the body to the morgue. A form is given to the medical examiner or pathologist to determine whether or not to conduct an autopsy. If the body requires an autopsy, the body is observed and then the family and officer is notified. A coroner would complete the full investigation and contact the family if needed.

Though they are not tasked with performing live medical procedures, coroners are still expected to bring a wide breadth of medical and anatomical knowledge.[x] Generally, these services are provided in cases of unexpected deaths, as mentioned previously, including, but not limited to: suicide, violent deaths, and deaths during surgical procedures. Therefore, it should come as no surprise that bodies can be found under different stages of decay for example. Because of the wide range of scenarios in which a body can be found, some deaths may be easier to investigate than other deaths. The cause of death in a controlled environment such as an operating room could be easier to find than the cause of death of a body suddenly found in the desert. Therefore, in order to determine the causes of these deaths, toxicologists and forensic pathologists will run tests on the body and present information to the medicolegal investigator, who compiles the information. Medicolegal investigators often work independently from law enforcement, while still engaging in legal affairs, in order to lessen bias.

Before the medical staff begin the autopsy, the medical examiner should provide them with information pertaining to the body’s identity. This includes basic identifiers such as “age, gender”, as well as “medical history”, and “circumstances of death.”[xi] In cases where the decedent cannot be identified, DNA testing can be a useful resource to figure out some crucial components of the decedent’s identity. According to Sanchez et al., “around 5-10%” of deaths requiring scrutiny by a medical examiner will be “classified as sudden unexpected deaths.”[xii] Though the case can be closed after this decision, the results can be unsatisfactory for both families and law enforcement. Thus, Sanchez et al. advocates for increased usage of gene sequencing in order to identify potential cardiac problems that may have led to the “sudden unexpected death.”[xiii]

 

A typical medical examination room in which identity, cause of death, etc., would be scrutinized.[xiv]

Basic information helps the medicolegal examiner and toxicologist contextualize their subsequent findings. During a toxicology investigation, tissues and fluids will be collected for analysis and will undergo “2-stage testing” composed of an initial screening to identify foreign chemicals, as well as an analysis to quantify the foreign chemicals. Many different factors will influence the results of a toxicology test, including but not limited to: food, other medications, and the degradation of certain chemicals in a specific timeframe.[xv] Food and medications can alter interactions between certain chemicals and the human body.[xvi] This presents a unique challenge to toxicologists, as different results will be acquired from different people. Though the deduction process is based on the toxicologist’s skill and the machinery available to perform analyses, strict national guidelines can introduce a more uniform process.

Examiners should be able to interpret medical results in order to deliver accurate and unbiased information to law enforcement, lawyers, judges, families, and even insurance companies. Accurate medical results are crucial in court cases and insurance claims. Though toxicology is important, not many medicolegal examiners are able to acquire their own lab. According to an infrastructure assessment performed by the National Association of Medicolegal Examiners (NAME), only “37% of medical examiner offices have their own toxicology laboratories.”[xvii] Offices without their own toxicology laboratories must request assistance from state or federal crime laboratories. In some cases, offices will contract a third party toxicology laboratory to perform much-needed analyses. Outsourcing the toxicology work creates a lag in which the body could wait weeks or even months before being tested. Even then, sometimes the toxicology reports may be incomplete. This creates problems for families, who may not be able to grieve for their departed, as well as law enforcement and court systems. Thus, it is evident that the scientific elements of the medicolegal death investigation system have many implications on legal and ethical issues.

 

Toxicology labs require extensive equipment and materials which are not always readily available to every ME office.[xviii]

As with any other medical procedure, one performed after death is very important.  David Spain writes that “Medicolegal investigation of death, in the past decade, has assumed an increasingly important role extending far beyond the immediate investigation of suspected homicide, suicide, or accidental death.”[xix]  Today’s complex issues such as the ease of malpractice with optimized technology, minority groups and violent deaths (police brutality), and others all call to question many ethical, legal, and moral concerns surrounding the field of medicolegal death and its investigations.

Before even diving into the ethical issues surrounding the actual investigations done, it’s important to note who is actually conducting the examinations.  As mentioned before, the first major concern for the public today is the ethical issue of medicolegal examiner qualifications.  Depending on state regulations, either county coroners, county medical examiners, or a mix of both will undergo death investigations.[xx]  With the weight and importance that investigations have on legal implications and convictions, there is rightful concern surrounding the quality of these medicolegal investigators and the accuracy of their rulings for cause of death, etc.  Yet despite the importance of these investigations, there is a lack of standardized qualifications for medical examiners and coroners who engage with the deceased.  Diane Kelsall and her colleagues argue that “there is no accreditation system for coroner or medical examiner offices, no national standards for the investi­gation or classification of death, no nationally recognized train­ing program or credentialing system for coroners and medical examiners, and no agreement on common outcome measures against which to evaluate performance.”[xxi] Her concern has merit considering that in coroner systems, the only requirements for a coroner to be elected are that the candidate must live in the county/state for a specified number of years.  There is no training, additional education, or certification required.  In contrast, medical examiners are usually licensed physicians that practice medicine, and are appointed by county officials.[xxii]  The wide spectrum of death investigators can cause concern regarding the differing quality of service between the deceased.

 

This map shows the varying systems used between states, from coroner or ME exclusive systems to mixed ones.[xxiii]

An ethical issue that can potentially arise from lack of medical experience or qualifications is that regarding errors during the course of the investigation.  While sufficient qualifications may not always be the cause of error, there are questions concerning whether or not these errors warrant acknowledgement.  Dwayne Wolf addresses this “gray area,” stating that “When the error is significant but did not lead directly to the patient’s demise, the questions may arise regarding the obligations of the medical examiner to disclose the error to the clinicians or to the family.”[xxiv]  For example, a male with a pacemaker is found incapacitated, and resuscitative measures are taken as he is transported to a hospital.  Due to “pulseless electrical activity,” resuscitative measures were terminated, and it was determined that cause of death was toxicity of a combination of drugs.  Yet, an interrogation of a pacer-defibrillator technician revealed that after resuscitation effort ceased, there were ventricular arrhythmias that triggered internal shocks from the defibrillators.  While this did not cause the death of the patient, the ethical question on whether or not the ME should report these findings and inform the family remain.  Generally, because this was not the cause of death, it would not be reported on the death certificate or autopsy report.[xxv]

Therefore, the ethical issue of full disclosure is one that continues to be debated today.  Some argue that the ME has a “duty to uphold ethical standards of professional practice, which include to not misrepresent data upon which conclusions are based.”[xxvi] If an ME decides to disclose these findings, there is usually confusion as to who to report them to.  An option is to open dialogue with the quality director of the institution of the physician who was in charge of treating the deceased.  While informing the physicians of the findings will not change the cause of death or the outcome of the deceased, initiating conversation and spreading awareness of the incident may build trust and help prevent any future issues.

Finally, just as transparency and trust would be beneficial between physicians and MEs, the same can be said about the representation of information in trials and convictions.  Praveen Yadav outlines the basic standards for medicolegal investigators giving their testimonies, stating that, “Laboratory results together with the expert’s opinion that interprets them must never be falsified, trimmed, tailored or otherwise modified to suit a third party, be the motive political, military, racial, financial or any other.”[xxvii]  As clear-cut as this may seem, there’s room for moral and ethical dilemmas in the courtroom.  Some investigators misrepresent the degree of their educational degree or professional status by associating their eligibility for higher certification as actually obtaining it.  Exaggerations in experience are often a tactic to intimidate cross-examination efforts.[xxviii] On the contrary, some investigators and scientists battle the task of ethically presenting interpretations of data in a way that is objective and understandable to the jury.  The use of medical jargon, complicated scientific concepts, and confusing evidence could lead to deception, especially to jurors who are unaware of those things.  This is a result of lack of courtroom training of medical examiners and coroners.[xxix]  Perhaps the largest ethical and moral difficulty faced by investigators is remaining objective.  Yadev writes, “They must not forget that objectivity is their main attribute and that they must examine all the angles before reaching conclusion.”[xxx] This could be difficult to do if, for example, the examiner knows that he/she is defending a murderer.

Some evidence provided by coroners/MEs can be confusing to a lay-person of a jury.[xxxi]

Overall, there are many ethical and moral issues that intertwine with legal implications, such as conviction of crimes.  Understanding these in conjunction with the history/development, and scientific practices of the medicolegal system does raise concern, especially as social issues and controversial turmoil continue to plague the Earth.  However, awareness of the many working parts and concerns of the system can help initiate dialogue about ways to improve issues and ameliorate the quality of medicolegal investigations.

 

Meredith Hou

Yaeelin Merino-Velasquez

Quynh Nguyen

 

NOTES

[i] Spitz, Werner U., Daniel J. Spitz, and Russell S. Fisher. Spitz and Fishers Medicolegal

Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation. Springfield, IL: Charles C. Thomas, 2006.

[ii] “What is a Coroner?” How to Become a Crime Scene Investigator. Accessed April 07, 2019.

https://www.crimesceneinvestigatoredu.org/coroner/

[iii] Hanzlick, Randy. Death Investigation: Systems and Procedures. Boca Raton: Taylor & Francis, 48-60 2007.

[iv] Hanzlick, Randy. Death Investigation: Systems and Procedures.Boca Raton: Taylor & Francis, 35 2007

[v] “Office of Butterworth & Sons, Undertakers,” from brochure Seattle and the Orient (1900). https://justiceforraymond.wordpress.com/2012/07/25/who-regulates-coroner-medical-examiners-and-their-facilities/

[vi] National Conference of Commissioners on Uniform State Laws, “Model Post-Mortem Examination Act.” 9-14 Aug. 1954, https://netforumpro.com/public/temp/ClientImages/NAME/3301a8d5-4f77-4f70-92e9-ebec0b7598a8.pdf.

[vii] National Conference, “Model Post-Mortem Examination Act.”

[viii] [5] Kelsall, D.,M.D.M.Ed, & Bowes, M. J., M.D. (2016). No standards: Medicolegal investigation of deaths. Canadian Medical Association. Journal, 188(3), 169. doi: http://dx.doi.org/10.1503/cmaj.160041

[ix] Hanzlick, Randy. Death Investigation: Systems and Procedures.Boca Raton: Taylor & Francis, 92-95 2007.

[x] “Who Are You Calling a Death Investigator?” PBS. Accessed April 09, 2019. https://www.pbs.org/wgbh/frontline/article/who-are-you-calling-a-death-investigator/.

[xi] Basso, Cristina, Margaret Burke, Paul Fornes, Patrick J. Gallagher, Rosa Henriques de Gouveia, Mary Sheppard, Gaetano Thiene, and Allard van der Wal. “Guidelines for autopsy investigation of sudden cardiac death.” Virchows Archiv 452, no. 1 (2008): 11-18.

[xii] Sanchez, Olallo, Oscar Campuzano, Anna Fernández-Falgueras, Georgia Sarquella-Brugada, Sergi Cesar, Irene Mademont, Jesus Mates et al. “Natural and undetermined sudden death: value of post-mortem genetic investigation.” PLoS One 11, no. 12 (2016): e0167358.

[xiii] Sanchez et al. “Natural and undetermined sudden death: value of post-mortem genetic investigation.”

[xiv] Autopsy Table, unknown author, https://www.wisegeek.com/what-is-a-medical-examiner.htm

[xv] Skopp, Gisela. “Postmortem toxicology.” Forensic science, medicine, and pathology 6, no. 4 (2010): 314-325.

[xvi] Skopp, “Postmortem toxicology.”

[xvii] Graham, M. A., F. B. Jordan, and V. W. Weedn. “Preliminary report on America’s medicolegal offices. The National Association of Medical Examiners. 2004.”

[xviii] Toxicology Lab, unkown author, https://www.news5cleveland.com/news/local-news/cleveland-metro/cuyahoga-countys-medical-examiner-office-uses-dna-to-identify-bodies-solve-sex-crimes-cold-cases

[xix] Spain, David M, “Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation.” JAMA, 1973;226(13):1574. doi:10.1001/jama.1973.03230130062041

[xx] Pearsall, Beth, “Improving Forensic Death Investigation.” National Institute of Justice, no. 267 (March 3, 2011): 30-33. Accessed April 4, 2019. https://www.nij.gov/journals/267/pages/investigation.aspx.

[xxi] Kelsall, Diane, M.D.M.Ed and Matthew J. Bowes M.D, “No Standards: Medicolegal Investigation of Deaths.” Canadian Medical Association, Journal 188, no. 3 (Feb 16, 2016): 169. doi:http://dx.doi.org/10.1503/cmaj.160041. http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1768826205?accountid=14244.

[xxii] Ernst, Mary Fran, “Medicolegal Death Scene Investigation.” AccessScience (McGraw-Hill Education, 2009). https://doi.org/10.1036/1097-8542.YB090131.

[xxiii] Death Investigation State-By-State, unknown author, https://www.npr.org/2011/02/03/131242432/graphics-how-is-death-investigated-in-your-state

[xxiv] Wolf, Dwayne A., et al, “Ethical Considerations on Disclosure When Medical Error Is Discovered During Medicolegal Death Investigation.” The American Journal of Forensic Medicine and Pathology, 38, no. 4 (December 4, 2017): 294. doi:10.1097/PAF.0000000000000343.

[xxv] Wolf, “Ethical Considerations,” 295.

[xxvi] Wolf, “Ethical Considerations,” 295.

[xxvii] Yadav, Praveen Kumar. “Ethical Issues Across Different Fields of Forensic Science.” Egyptian Journal of Forensic Sciences, 7, no. 1 (July 18, 2017): 2. Accessed March 30, 2019. doi:10.1186/s41935-017-0010-1.

[xxviii] Yadav, “Ethical Issues,” 2.

[xxix] Yadav, “Ethical Issues,” 2-3.

[xxx] Yadev, “Ethical Issues,” 3.

[xxxi] Former Chief State Medical Examiner Gary Dale Testifies, Kurt Wilson, Missoulian, https://helenair.com/missoula/news/local/forensic-pathologist-will-no-longer-do-work-for-montana-county/article_05559668-76af-530c-9257-d64480a6d228.html

 

The CSI Effect

Entertainment media is a major part of American culture, specifically television entertainment. Studies have been conducted in order to determine the ways in which television influences our thinking, and one such theory resulting from the research was developed in the 1960’s and labelled “cultivation”. Cultivation “affirmed that people who are avid television viewers tend to accept the content distributed through the television media and embrace the material as factual reality.”[1] The idea that people will unquestionably accept what they watch on television to be fact may be overreaching, however, it does seem clear that media- whether it be entertainment television, social media, the news, the radio- all play a role in influencing their audiences’ understanding and perception of the topics being portrayed. This idea of cultivation displays itself in Americans’ perceptions of crimes as determined by their viewing of crime-based entertainment.

The topic of crime remains extremely popular in the entertainment business, reflected by television viewer ratings; “Eight crime dramas, including CSI: Crime Scene Investigation and its sibling programs, made it into the top 20 shows last October. On one Thursday that month, 27 percent of all American televisions that were turned on were turned to CSI.”[2] The popularity of crime shows among the American public has been explained by Time as, “a specific manifestation of its more general fixation on violence and calamity.”[3] Additionally, they claim that people are intrigued by crime because, “it triggers the most basic and powerful emotion in all of us-fear.”[4] Regardless of why people are interested in crime television shows, the reality is that Americans are watching them with consistency. Though watching television can be considered a harmless and passive activity, when viewing television’s influence through the lens of cultivation it is clear that Americans use crime-based entertainment media as their source of information on the investigative processes following a crime.

According to an article written by Kristina Ericksen, the CSI Effect is a phenomenon discovered by prosecutors that illustrates how crime shows, like CSI: Crime Scene Investigation, alters jurors’ courtroom expectations.[5] In turn, this makes it more difficult to convict the defendants with solid evidence. Ever since these crime shows have become popular, judges have wanted more and more evidence to convict someone, even when the truth behind the fingerprints is right in front of them. Because these television programs have been widely shown around the world, the CSI Effect has influenced American jurors to expect more forensic evidence to convict defendants of crimes.

Forensic science is any science that is used in the legal system that applies to civil proceedings and criminal cases. Forensic scientists work with the investigators at the crime scene to collect evidence and traces to help determine more information from the crime scene. Although strict procedures must be followed during real-life crime scene investigations, television programs don’t usually show the realistic steps of the investigation process. These crime scene investigations programs often shape the public’s expectations of what a true crime scene investigation looks like.[6]

According to the Microbiology Society, forensic scientists must follow strict procedures when collecting evidence such as bodily fluids, trace materials, fiber identification, toxicology, and fingerprints.[7] The first step of any crime scene investigation is to ensure the safety of the scene and mark off any hazardous areas that can influence the collection of specimens. Forensic scientists need to outline the area of investigation to ensure that no evidence is destroyed by medical, fire or coroner respondents. The second and most important step of any crime scene investigation is to establish security of the scene to ensure that everyone that enters the scene is documented. This helps investigators know exactly who has stepped foot on the crime scene that could have obstructed or collected evidence. The next important step in the crime scene investigation procedure is to plan, communicate and coordinate with all persons investigating the crime scene. Investigators want to generate an initial hypothesis of the crime to help the crime scene team expect what evidence to look for. This ensures that no evidence is looked-over and missed while collecting data, and allows the team to call in backup if a more specialized resource is required to gather evidence.

Before collecting any evidence, the team needs to walk through the crime scene and document any initial observations they notice; position of furniture, areas of interest, smells, and the temperature; these observations are typically photographed and documented on paper for future references. This step guarantees that every detail of the crime scene is documented in case something was to be obstructed during the collection of evidence. Once the scene becomes safe and the walkthrough has been completed, the following initiative is to collect the evidence from the crime scene. Proper procedures must be followed while containing the evidence found at the scene so that it can be tested in the future. Investigators also take more photographs of the evidence and sketch diagrams that would provide more information of the evidence collected. As a control step, investigators will run through the crime scene one final time to ensure that all useful data has been properly collected from the crime scene. The final step of any crime scene investigation is to create an inventory log of all evidence collected during the investigation process. This documentation will follow the crime all the way into the courtroom until someone has been convicted. All information from this log ensures that the evidence collected at the crime scene is accounted for.[8]

Once every step of the procedure has been completed, forensic scientists can then use this evidence to help convict the defendant involved. This information is most important in any criminal case because it provides hard evidence to convict the guilty.

Many current crime scene investigation television programs falsely demonstrate the proper legal procedures of real crime scene investigations. These programs often show investigators quickly running through crime scenes and improperly collecting evidence. This gives jurors a false idea of how the investigation process actually works. Many jurors today expect DNA evidence from every crime scene using top-notch technology that has not actually been developed.[9] The CSI Effect has caused jurors to expect more hard evidence than needed to convict someone.

An image depicting a crime scene investigation that took place on CSI Miami: Crime Scene Investigation. This photograph illustrates the false procedures that take place on television programs. 

There are several effects of using fiction television as a basis for understanding real-life processes following a crime, a main one being peoples’ misunderstanding of the forensic procedures. The danger of viewers’ act of interchanging fiction with fact is the unrealistic expectations that are placed on the criminal justice system, as well as the data processing of forensic evidence. Crime television programs have been identified as the culprits for giving, “the impression that forensic laboratories are fully staffed with highly trained personnel, stocked with a full complement of state-of-the-art instrumentation and rolling in the resources to close every case in a timely fashion.”[10] The interpretation of forensic science given by crime television shows is not all that accurate, as in reality there are not enough employees to keep up with the increasing demands being placed on labs for data analysis.

An additional effect of using crime-based entertainment as a basis of understanding the forensic and legal investigative processes is the previously defined phenomenon, the CSI effect, which is “the belief that television crime shows are affecting decisions made in the courtrooms from jurors.”[11] According to the CSI effect, jurors are imposing unrealistic expectations on crime scene evidence in order to prosecute a crime; thus, the aforementioned increasing demand for data analysis from forensic labs can be attributed to this phenomenon. One such example of the increasing demand for crime scene evidence occured in Virginia, where “in 1989 Virginia labs processed only a few dozen cases. The number of cases being submitted this year has ballooned into the thousands.”[12] This increasing demand for forensic evidence ties to the legal proceedings following a crime, as jurors assume that evidence is the unarguable proof of a defendant’s guilt.

The influence of the CSI effect was studied as it impacted New York State prosecutors, and there appeared to be a relationship between jurors’ increased demand for forensic evidence and their likelihood of persecuting the individual on trial. As stated by the study, “In some instances, legal employees had to practice ‘defensive investigations’ using forensic evidence, not because it was involved in the case, but rather to satisfy the intrigue of the jury.”[13] According to the research study- despite consistent debate about whether the CSI effect is real- prosecutors are changing their tactic in the courtroom in order to account for the jurors misconceptions about the investigative crime procedures. Another aspect of the study states, “I have found jurors now expect more evidence than they did before. They want to see DNA testing in every case. They expect police officers to fingerprint every square inch of a crime scene. In a way, it feels as though our burden of proof is raised; non-forensic evidence must be much stronger in the absence of forensic evidence”[14] Thus, not only are forensic analysts facing more pressure, but prosecutors have to alter their arguments in order to convince jurors of the defendant’s guilt when facing a lack of crime scene evidence as well.

Though forensic evidence is not always necessary in order to justifiably deem an individual to be guilty (such as by eyewitness testimony), it arguably goes further in convincing a jury of guilt. Crime’s ever present influence and intrigue among the American public can be summarized by the statement, “Crime remains an unfortunate, yet integrated part of American culture, not as hopelessly interwoven as the media would have use believe, but regardless, a part of life (or at least the evening news).”[15] Regardless of the degree to which the CSI effect truly explains entertainment television’s impact, the influence of television on the public’s understanding of crime remains inevitable; the extent to which the legal and forensic processes change based on the cultural influences of entertainment media will be determined as they occur.

Ethics is a huge part of crime scene investigations, and law enforcement officers going through these processes are expected to investigate the case with ethics and morals in their minds. Police and forensic specialists are obliged to preserve the integrity of their investigations. The American Academy of Forensic Sciences provides no guidelines for crime scene ethics or retention of items from former crime scenes.[16] Without these guidelines, there are no rules that regulate whether or not someone can keep, remove, or sell anything found during a crime scene investigation.

Ethics is a huge part of crime scene investigations, and law enforcement officers going through these processes are expected to investigate the case with ethics and morals in their minds. Ethics can be defined as the “moral principles that govern a person’s behavior or the conducting of an activity”.[17] Police and forensic specialists are obliged to preserve the integrity of their investigations. The American Academy of Forensic Sciences provides no guidelines for crime scene ethics or retention of items from former crime scenes.[18] Without these guidelines, there are no rules that regulate whether or not someone can keep, remove, or sell anything found during a crime scene investigation which is why it is so important to use ethics in your practices.

What exactly does ethics mean for a Crime Scene Officer (CSO)? As a CSO it is your role first and foremost to help the public and to understand that you are called to a crime scene because something is wrong. Never “jump the gun” on a case because you cannot force evident to fit someone’s ideas. Go into each case unbiased, and let the evidence speak for itself. Officers must be aware that they are not able to let their personal feelings interrupt objective, critical, and reflective consideration of the case.[19] It is important to approach each scene with the attitude that you’re there to help the victim(s), assume that each case is going to a jury trial, act professionally, take the time to process each scene, and ultimately solve the case.[20] There is also a set of directions on how to process each scene professionally. It starts with stressing the importance of documenting everything thoroughly using photography, videography, diagrams, and sketches. Then, it is important to record all information about evidence that is found on the Evidence Custody Sheet. You should list each piece of evidence with its item number, what was done with it, where it was found, etc. and the item number must correspond with the number found on the photograph of the item and the number entered on any evidence collection bag. When appropriate, you must swab and collect evidence in that way. One of the most important things to remember as a CSO is to not ignore evidence because you do not think that it can be processed,  recognize your limits. Dick Warrington, a crime scene consultant, stressed that “It’s far better to call in fingerprint or other experts than to lose evidence because of your pride”.[21]

A large part of ethics is being morally right which brings out the idea of whether or not evidence from crime scenes should be released to the public before court. A conversation between Katherine Biber, a law professor, and Peter Doyle, a researcher of crime scene photographs, joined a conversation about the ethics at crime scenes.[22] The biggest reason why evidence should not be released to the public, especially before court, is because people will start to question and try to get involved with the investigation even though they should not. This is especially due to the theory of the “CSI Effect”. After watching a couple of CSI shows, the public thinks that they can solve the crime and their interference can actually do more harm than good. Crime scene photos also are a big part of being able to properly, and ethically, solve a case due to its authenticity. Some of the ethical rules behind crime scenes is to not touch or interfere with anything and leave it exactly how it is. A lot of times pictures can be confusing because it becomes difficult to realize what exactly you’re looking for. In response to this statement, Peter Doyle said “I’m so good at unpacking them, decoding them- you can see how they manipulate us, you can see the mythic underpinnings”.[23] Many people in the public if photographs were released would attempt to make a bigger deal of something than it needed to be rather than letting the professionals who are trained to look at these photographs figure it out for themselves.

Crime scene photos and other evidence being released to the problem also brings out the ethical problem in the “CSI Effect”. Reality and fiction have begun to blur with crime magazine TV shows like 48 Hour Mystery, American Justice, and Dateline NBC.[24] These shows portray actual cases, but extensively edit the content for a dramatic effect. Also, crime fiction TV drama shows like Law and Order, Criminal Minds, CSI promote plots that are “ripped from the headlines”. It has been proven that watching shows like this cause jurors to wrongfully acquit guilty defendants when no scientific evidence has been presented. Donald Shelton, a felony trial judge for the past 17 years, recalls that he once heard a juror complain that the prosecution had not done a thorough job because “they didn’t even dust the lawn for fingerprints”. These shows have caused a rise in the unreasonable expectations for evidence that is presented during a trial. Many jurors compare cases that they are in trial for to ones that they hear about and watch on TV. Some statistics that support how the “CSI Effect” is real in court cases are as follows: 46% of jurors expect to see some kind of scientific evidence in every criminal case, 22% expect to see DNA evidence in every criminal case, 36% expect to see fingerprint evidence in every criminal case, 32% expect to see ballistic or other firearms lab evidence in every criminal case.[25]

 

Bria Bryant

Kayla Bortoff

Lauren Meyer

[1] Erickson, Elizabeth. Perceptions of the CSI-Effect by New York State Prosecutors and Forensic Science Requests at Trial. Northcentral University: Proquest Dissertations Publishing, 2015. http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1759209998?accountid=14244.

[2] Houck, Max M. “CSI: Reality.” Scientific American 295, no. 1 (July 2006): 84–89. https://www.jstor.org/stable/26068885. (pg. 85)

[3] Bonn, Scott . “Why We Are Drawn to True Crime Shows.” Time. TIME, January 8, 2016. http://time.com/4172673/true-crime-allure/.

[4] Ibid.

[5] Kristina Ericksen, 7 Ways the CSI Effect is Altering Our Courtrooms, (2017). Retrieved from: https://www.rasmussen.edu/degrees/justice-studies/blog/ways-csi-effect-is-altering-our-courtrooms/

[6] Michael Roberts, How the CSI Effect Influences American Jurors, (2019). Retrieved from: https://www.thebalancecareers.com/csi-effect-1669447

[7] Lorna Dawson/ Chris Gannicliffe, Managing the Myths, CSI Effect in Forensic Science, (2017). Retrieved from: https://microbiologysociety.org/publication/past-issues/microbiology-in-popular-culture/article/managing-the-myths-the-csi-effect-in-forensic-science.html

[8] National Forensic Science Technology Center, A Simplified Guide to Crime Scene Investigation, (2013). Retrieved from: http://www.forensicsciencesimplified.org/csi/how.html

[9] Donald Shelton, The ‘CSI Effect’: Does It Really Exist?, (2008). Retrieved from: https://www.nij.gov/journals/259/pages/csi-effect.aspx

[10] Houck, Max M. “CSI: Reality.” Scientific American 295, no. 1 (July 2006): 84–89. https://www.jstor.org/stable/26068885.

[11] “The CSI Effect.” Crime Museum. Crime Museum, 2017. https://www.crimemuseum.org/crime-library/forensic-investigation/the-csi-effect/.

[12] Houck, Max M. “CSI: Reality.” Scientific American 295, no. 1 (July 2006): 84–89. https://www.jstor.org/stable/26068885.

[13] Erickson, Elizabeth. Perceptions of the CSI-Effect by New York State Prosecutors and Forensic Science Requests at Trial. Northcentral University: Proquest Dissertations Publishing, 2015. http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1759209998?accountid=14244.

[14] Ibid, 25.

[15] Durnal, Evan W. Crime Scene Investigation (as Seen on TV). University of Central Missouri: Forensic Science International, 2010. https://doi.org/https://doi.org/10.1016/j.forsciint.2010.02.015.

[16] Rogers, Tracy L. “Crime Scene Ethics: Souvenirs, Teaching Material, and Artifacts.” Journal of Forensic Sciences49, no. 2 (April 2004): 1-5. Accessed April 8, 2019. doi:10.1520/jfs2003287.

[17] “Ethic.” Merriam-Webster. Accessed April 08, 2019. https://www.merriam-webster.com/dictionary/ethic.

[18] Rogers, Tracy L. “Crime Scene Ethics: Souvenirs, Teaching Material, and Artifacts.” Journal of Forensic Sciences49, no. 2 (April 2004): 1-5. Accessed April 8, 2019. doi:10.1520/jfs2003287.

[19] McCartney, Steve, and Rick Parent. Ethics in Law Enforcement. April 17, 2015. Accessed April 08, 2019. https://opentextbc.ca/ethicsinlawenforcement/chapter/4-4-ethical-issues-during-an-investigation/.

[20] Warrington, Dick. “Ethics at the Crime Scene.” Forensic Magazine. June 14, 2016. Accessed April 08, 2019. https://www.forensicmag.com/article/2015/09/ethics-crime-scene.

[21] Ibid.

[22] Biber, K., Doyle, P., & Rossmanith, K. (2013). PERVING AT CRIME SCENES: Authenticity, ethics, aesthetics: A conversation. Griffith Law Review, 22(3), 804-814. Retrieved from http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1549242682?accountid=14244

[23] Ibid.

[24] Shelton, Donald E. “The CSI Effect: Does It Really Exist?” PsycEXTRA Dataset, 2008. Accessed April 8, 2019. doi:10.1037/e444972008-001.

[25] Ibid.

Criminal Evidence in Gun-Related Homicides

The United States has a long history of guns, tracing back to before the American Revolution. They were used by freemen in British North America for protection against “the Native Americans, the French, and others” [[1]]. Back then they were very difficult to use, but in 1840, the Colt revolver became popular, because it was more efficient, cheaper, and more easily concealed. Along with the increase in Colt revolvers came “an increase in homicide rates” [[2]]. The culture around guns has made the United States the country with “the highest rate of gun homicide in the industrialized world. In 2009, there were 13,636 murders by weapons (out of 15,241 total murders) in the United States. Of these murders, 9,146 were committed with firearms, handguns being the weapon of choice” [[3]]. This data further proves that guns are ingrained in American society, and used to harm others.  The second amendment in the Constitution, the right to keep and bear arms, is one of the most important rights to most Americans because guns are deeply rooted in our culture.

 

 The table above shows the estimated percentage of American Gun Presence in households, comparing pre-industrialization and post-industrialization [[4]].

 

Today, the United States ranks number one in firearm ownership per capita and we dominate in firearm‐related death on a global scale [[5]]. Many believe that because of the high rates of homicides and mass shootings that have been prevalent in recent years, there should be stricter gun laws. There has been an ongoing debate about gun control, where “proponents of stricter gun control argue that guns are responsible for 32,000 gun‐related deaths each year and that the introduction of stricter gun control laws would reduce this death toll” [[6]] On the other hand, gun rights advocates argue “that the general availability of guns reduces homicide rates, due to deterrence and because guns are effective means of self‐defense” [[7]]. The supporters of gun rights believe that guns will help prevent more homicide, but research shows that gun prevalence is positively related to homicide rates [[8]], indicating that the more guns available to the public, the more homicides will occur. The group of people against gun control have no validity to their argument but demonstrate that their beliefs and cultural values are strong enough to fight for gun rights.

There is a violent trend which traces back over centuries involving the use and misuse of firearms, so it should come as no surprise that American forensics have developed and utilized specific techniques and resources to deal with gun-related homicides. Many of these techniques rely heavily on technology and are gaining popularity as gun-related homicides continue to increase. One example of the technology being used in gun-related homicides includes the use of 3D modeling software to help forensic scientists accurately reconstruct a postmortem and skeletonized skull with a bullet wound. This technology is useful in cases of “no further evaluable brain,” and can aid forensic scientists in documenting the path of the bullet and therefore identify which brain structures were damaged and the ability of action in those parts of the brain are associated with the damage.

A study that used postmortem 3D reconstruction of gunshot wounds to the skull, found that concordance rates between the reconstructed bullet trajectory and the autopsy reports were “excellent” for over half of the sample [[9]]. The results produced by the study are useful in depicting the accuracy of 3D reconstruction of the skull and therefore the bullet trajectory as it compares to the actual autopsy reports for each of the cases. This technique is useful in cases of advanced decaying and skeletonizing of the victim’s’ body because it can assist in the assessment of which parts of the brain were destroyed prior to death and can help in determining the trajectory of the bullet.

Another type of technology used to assess gun-related homicides is the 3D Ballistic Trajectory Model, used primarily to determine the trajectory of the bullet, in cases with conflicting evidence and testimony. In this form of 3D modeling, forensic scientists use the heights of the victim and the shooter as well as the postmortem position of the victim, bullet entry and exit, and lodgment points, to simulate a 3D model of the crime scene. This model would include the entire scene – down to the placement of buildings, sidewalks, and physical evidence. This form of modeling may also include the point of view of any eyewitnesses in order to assess their visibility and orientation at the time of the incident.

Using the 3D Ballistic Trajectory model, forensic scientists can manipulate the body posture of both the shooter and the victim in an attempt to align the trajectory of the bullet path with the actual documented entry point. This helps forensic scientists provide clarity on a situation in which there may be several conflicting testimonies. For example, one study using this technique in a case in which a cop fatally shot a man, found that the cop’s description of the events that occurred was actually determined impossible after 3D modeling the bullet path. This helped in bringing justice to the victim [[10]].

However, as forensic technology advances and is continuously incorporated into homicide cases, firearms themselves are advancing in power, speed, and even ammunition composition. The advances in gun technology can further complicate a forensic analysis of a gun-related homicide. Previously, gunshot residue (GSR) was easily analyzed using electron microscopy and energy dispersive spectroscopy, which provides information regarding particle composition and primer residue. This was used to help guide a forensic scientist towards identifying the gun and the ammunition type used by the shooter. However, now, lead-free and non-toxic ammunition is available, which leaves a different kind of GSR called “Organic” GSR and this is much more difficult to pick up using energy dispersive spectroscopy techniques.

Luckily, new forms of identification have been adopted by forensic scientists including gas chromatography, liquid chromatography, and infrared spectroscopy. Using infrared spectroscopy, luminescent chemicals in GSR can be detected under UV radiation. One study involving the accuracy of infrared spectroscopy found that after setting up a “crime scene” involving a drive-by shooting, luminescent GSR could be detected in the car, in the nostrils and on the forehead of the shooter, and up to 9.4m from where the bullet left the gun. This study also found that luminescent GSR could be picked up on the shooter’s hands for up to 9 hours after the crime had been committed, considering hand-washing [[11]].

The accuracy of testing utilizing the analysis of GSR to determine shooting distance and powder identification is supported by other studies. A study using atomic force microscopy to analyze GSR particles found that the dispersion of particles had a correlation with the distance that the bullet traveled. This study also identified differences in the spectra of “pre-shot gun powder” from three different cartridges. The findings of this study may help forensic scientists identify suspects of homicides as this method can identify details such as the distance of the shot and the manufacturer of the bullet [[12]]. These findings help forensic scientists gather more information about the location of the shooter, the path of the bullet, and possible suspects in cases where the shooter may not have been seen or found, as these LGSR particles transfer onto other objects touched by the shooter.

These new technological findings greatly aid in the case of prosecution. Prosecutors have a moral obligation to ensure that justice arises, no matter the case. One way that the US has begun to use these new technological methods to place justice above all else is through gun courts. These are specialized courts that deal only with firearm related offenses. Now, it is very important to differentiate between juvenile and adult gun courts. Juvenile gun courts focus on providing intervention for young offenders involved with firearms. These are much more education-centric, intending to prevent future crimes by informing young offenders of the weighty consequences. Adult gun courts have slightly different goals. They aim to get violent offenders off the streets as quickly as possible and to dole out harsh sentences to these violent offenders [[13]]. By streamlining a specific type of case through a different route, the justice system intends to allow courts to focus only on firearms and move much more quickly than a regular court. Justice demands that violent offenders, especially ones associated with so dangerous a weapon as a firearm, be removed from the public immediately, so that they may not pose any greater threat to the public. The harsher sentences, as well, are perceived as deserved and a hopeful deterrent against further violent behavior involving firearms. With a promising prosecution rate of nearly 80% for all federal and state arrests made related to guns [[14]], it seems these gun courts are doing something of a good job. Therefore, gun courts are fairly accepted as a method of prosecution.

However, adult gun courts do raise a question of fairness. Is it true justice to divide offenders based primarily on their weapon of choice? By putting firearm-related cases in one division, the court itself creates a bias that is then used to give these cases harsher outcomes. The harsher outcomes are actually an intended outcome of this system, which is also questionable. In the wake of stories about mass shootings and murder-suicides amongst families, it can be hard to question the current justice system because of the public views these acts as so heinous that whoever does them, must also receive a heinous punishment. The entire justice system revolves around making sure that the punishment fits the crime. Gun courts make this system a little murky when they automatically assume that if the crime involves a gun, it is already worse than if it did not involve a gun. The justice system also often makes the mistake of using unfair racial profiling in its course of action against criminals. This unfair course of action only adds to the biased nature of gun courts and the US government in general. Statistics from the NAACP show that African Americans and Hispanics comprise only around 30% of the U.S. population, but make up more than 50% of the U.S. prison population [[15]]. African American males are also more likely to die by firearm-related homicide than another other demographics [[16]]. This means that African American males are at a much greater danger when it comes to guns and violence, as well as the danger that comes from the very justice system that generates such a strong racial bias.

 

 The graph above represents findings from an eight-year study conducted by researchers at McGill University and the University of California – Davis about Firearm-Related and Non-Firearm Related Homicides [[17]].

The justice system is not the only source of unfair racial profiling, gun culture in the United States also shows a strong correlation to racism. In a racial discrimination study, it was found that 63.10% of minorities experience racial discrimination compared to 29.61% of Whites” [[18]] and according to another source, “symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites’ paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions” [[19]]. American culture is tied to racist and discriminatory acts through its past of slavery and other discriminatory laws. This culture still translates in today’s society and has an impact on the homicide rates in the US and therefore affects the proponents of gun control and gun rights advocates.

Another question involving the gun court system is whether or not it works. For juvenile gun courts, the question is even more difficult to answer. There are very few of them in operation and the outcomes of studies are not clear. Opponents of adult gun courts claim that they do achieve the main goals very well, expediting the process and providing harsh sentences. However, in the case of decreasing gun violence as a whole, these courts do not seem to make any progress towards that goal [[20]]. Ethically, another problem arises because if gun courts are not overall reducing the problem of firearm-related violence in America, should they even be in place? They take care of the immediate goal of short-term safer streets, but the harsher sentences don’t seem to be as deterring as they are meant to be.

The ethical issues involved in homicide as a whole, specifically gun-related incidents, extend much further than simply the perpetrator and the victim. A question of culpability arises, as there is an entire outer ring of actors involved in this act of violence, despite their absence during the actual act. There must be, of course, a murderer and a victim in every homicide. Some have multiple murders or multiple victims, but a very distinct line separates them. After the fact, law enforcement investigates and prosecutes the crime, following laws that the government had laid out. Now, ethically, law enforcement has a responsibility to ensure that justice prevails, just as much as the government must pass laws that will not allow murderers to escape justice.

Law enforcement and gun laws are vastly different when comparing the United States to other countries around the world. Often when compared to these countries, many conclude that Americans are seen as more aggressive or more violent “because it is in [America’s] nature to do so” [[21]]. U.S. Americans own nearly twice as many guns as the citizens of Yemen, the world number 2 in private gun ownership and more than twice the number of guns owned by the citizens of Switzerland, the number 3 in private gun ownership [[22]].

 

The table above shows a comparison between European and American Murder rates during the pre-industrialized era and the post-industrialized era [[24]].

 

In one study, Americans are also shown to own a significant amount more guns than Europeans, and therefore have higher murder rates, as seen in Table 2 [[23]]. It is seen to be part of U.S. culture for Americans to be violent or angry and violence is often tied to guns in America, especially when talking about homicide. “In 2005, 68% of homicides were committed by criminals armed with guns” [[25]]. The normalization of gun-related homicides permeates in media through movies, TV shows and video games. Many people have become so desensitized to the violence that once it transfers to real-life scenarios, there is significantly less impact. Because guns are so deeply rooted in American society, homicide is now an additional part of American culture. The extreme violence that is so prevalent in the media perpetuates the same violence that so many Americans face today. Despite forensic and legal efforts to achieve justice in the cases of homicide, there is still a strong presence of both firearms and violence in society.

Joanna Delgado

Megan Northrup

Alexa Baldwin

 

[1] Innis, Kim A. Mac. “Homicides, Gun.” In Guns in American Society: An Encyclopedia of History, Politics, Culture, and the Law, by Gregg Lee Carter. 2nd ed. ABC-CLIO, 2012. http://libproxy.lib.unc.edu/login?url=https://search.credoreference.com/content/entry/abcguns/homicides_gun/0?institutionId=1724

[2] Ibid.

[3] Ibid.

[4] Monkkonen, Eric. “Homicide: Explaining America’s Exceptionalism.” The American Historical Review 111, no. 1 (2006): 76-94. doi:10.1086/ahr.111.1.76. https://www.jstor.org/stable/10.1086/ahr.111.1.76?pq-origsite=summon&seq=7#metadata_info_tab_contents

[5] Lynch, Kellie R., and Dylan B. Jackson. “”People Will Bury Their Guns before They Surrender Them”: Implementing Domestic Violence Gun Control in Rural, Appalachian versus Urban Communities.” Rural Sociology. January 18, 2018. Accessed April 08, 2019. https://onlinelibrary.wiley.com/doi/full/10.1111/ruso.12206.

[6] Stroebe, Wolfgang. “Firearm Availability and Violent Death: The Need for a Culture Change in Attitudes toward Guns.” Analyses of Social Issues and Public Policy. November 23, 2015. Accessed April 06, 2019. https://spssi.onlinelibrary.wiley.com/doi/full/10.1111/asap.12100.

[7] Ibid.

[8] Ibid.

[9] Peschel, O., Szeimies, U., Vollmar, C., & Kirchhoff, S. 2013. Postmortem 3-D reconstruction of skull gunshot injuries. Forensic Science International (Online), 233(1), 45-50. doi:http://dx.doi.org/10.1016/j.forsciint.2013.08.012

[10] Galligan, Aisling A., Craig Fries, and Judy Melinek. 2017. Gunshot wound trajectory analysis using forensic animation to establish relative positions of shooter and victim. Forensic Science International (Online) 271, (Feb 01): e8-e13, http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1863559493?accountid=14244 (accessed April 1, 2019).

[11] Weber, I. T., Melo, A., Lucena, M., Consoli, E. F., Rodrigues, M. O., de Sá, G., . . . Alves, S. 2014. Use of luminescent gunshot residues markers in forensic context. Forensic Science International (Online), 244, 276-84. doi:http://dx.doi.org/10.1016/j.forsciint.2014.09.001

[12] Mou, Yongyan, Jyoti Lakadwar, and J. Wayne Rabalais. “Evaluation of Shooting Distance by AFM and FTIR/ATR Analysis of GSR.” Journal of Forensic Sciences, 2008. doi:10.1111/j.1556-4029.2008.00854.x

[13] Office of Juvenile Justice and Delinquency Prevention. “Gun Court Literature Review.” Office of Juvenile Justice and Delinquency Prevention. September 2010. Accessed March 2019. https://www.ojjdp.gov/mpg/litreviews/Gun_Court.pdf.

[14] Southwick Jr., Lawrence. “Enforcement of Gun Control Laws.” In Guns in American Society: An Encyclopedia of History, Politics, Culture, and the Law, by Gregg Lee Carter. 2nd ed. ABC-CLIO, 2012. http://libproxy.lib.unc.edu/login?url=https://search.credoreference.com/content/entry/abcguns/enforcement_of_gun_control_laws/0?institutionId=1724

[15] NAACP. “Criminal Justice Fact Sheet.” NAACP. Accessed April 2019. https://www.naacp.org/criminal-justice-fact-sheet/

[16] Riddell, Corinne A., Sam Harper, Magdalena Cerdá, and Jay S. Kaufman. “Comparison of Rates of Firearm and Nonfirearm Homicide and Suicide in Black and White Non-Hispanic Men, by U.S. State.” Annals of Internal Medicine. May 15, 2018. Accessed March 2019. https://annals.org/aim/fullarticle/2679556/comparison-rates-firearm-nonfirearm-homicide-suicide-black-white-non-hispanic

[17] Ibid.

[18] Lee, Randy T., Amanda D. Perez, C. Malik Boykin, and Rodolfo Mendoza-Denton. “On the Prevalence of Racial Discrimination in the United States.” PLOS ONE. Accessed April 06, 2019. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210698.

[19] Kerry O’Brien, Walter Forrest, Dermot Lynott, and Michael Daly. “Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites may Influence Policy Decisions.” PLoS One 8, no. 10 (10, 2013). doi:http://dx.doi.org/10.1371/journal.pone.0077552. http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/1447721518?accountid=14244.

[20] Yablon, Alex. “The Case for Gun Courts.” The Trace. September 24, 2015. Accessed April 2019. https://www.thetrace.org/2015/09/gun-courts-drug-courts-rochester-shooting/

[21] Lynch, Kellie R., and Dylan B. Jackson. “”People Will Bury Their Guns before They Surrender Them”: Implementing Domestic Violence Gun Control in Rural, Appalachian versus Urban Communities.” Rural Sociology. January 18, 2018. Accessed April 08, 2019. https://onlinelibrary.wiley.com/doi/full/10.1111/ruso.12206.

[22] Stroebe, Wolfgang. “Firearm Availability and Violent Death: The Need for a Culture Change in Attitudes toward Guns.” Analyses of Social Issues and Public Policy. November 23, 2015. Accessed April 06, 2019. https://spssi.onlinelibrary.wiley.com/doi/full/10.1111/asap.12100.

[23]  Monkkonen, Eric. “Homicide: Explaining America’s Exceptionalism.” The American Historical Review 111, no. 1 (2006): 76-94. doi:10.1086/ahr.111.1.76. https://www.jstor.org/stable/10.1086/ahr.111.1.76?pq-origsite=summon&seq=7#metadata_info_tab_contents

[24] Ibid.

[25] Kovandzic, Tomislav, Mark E. Schaffer, and Gary Kleck. “Estimating the Causal Effect of Gun Prevalence on Homicide Rates: A Local Average Treatment Effect Approach.” SpringerLink. October 11, 2012. Accessed April 06, 2019. https://link.springer.com/article/10.1007/s10940-012-9185-7.

 

 

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