I write in response to the column concerning the private consulting done by Maine’s chief medical examiner (Bill Nemitz, Feb. 17). Unfortunately, it relied more on innuendo than facts. The fact is that private consultation by medical examiners is a widespread, accepted practice that ultimately benefits society.
This country is facing a drastic shortage of forensic pathologists, which threatens to compromise the functioning of our medical examiner and coroner systems.
One major reason is that salaries offered to highly trained physicians who choose careers as government-employed medical examiners are substantially lower than those available in hospital practice. A physician faces a difficult choice: Take an extra year of medical training to work for a fraction of private practice pay, and in this era, try to pay off student loans that commonly amount to more than $200,000.
The judicial systems, criminal and civil, rely on expert consultants to provide pre-trial advice to attorneys and expert testimony that educates juries about the medical aspects of the case. Criminal defendants should have access to consultants to provide independent analysis of the evidence, which permits defense counsel to pursue the case realistically, and, when applicable, to present alternative interpretations of the medical evidence.
The medical examiner who does private defense consultation is demonstrably independent and unbiased, by not only being called as a witness by the prosecution. The civil justice system depends on medical consultants to provide expert opinions, such as in medical malpractice suits, which are routinely provided by physicians outside of their patient-care practices.
Private consultation by a government medical examiner is not unethical or inappropriate, provided that the private work and the government duties remain separated. It serves a necessary and required function within our justice systems, and demonstrates the intellectual independence of the consultant.
Jonathan L. Arden, M.D.
2019 president, National Association of Medical Examiners
McLean, Va.
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