Reviewed by Lynne Curry (Eastern Illinois University)
Published on H-Law (October, 2011)
Commissioned by Christopher R. Waldrep (San Francisco State University)
Medicine of the Forum
Katherine D. Watson has produced a superb synthetic work of medical and legal history that is sweeping in its narrative scope while at the same time attentive to manifold key differences in legal and medical thought and practice, both among nations and over time. Although the body of the work comes in at an efficient 150 pages, Watson’s writing is so lucid that readers will come away with a solid foundational understanding of the definition, history, purpose, and meaning of forensic medicine in Western society. Undoubtedly, many will also find themselves eager to learn more.
Watson introduces the book by clearly laying out and defining her terms. On the one hand, forensic medicine is “concerned with the body, and with the effects on the body of acts of violence,” which in our own times distinguishes it from the closely related disciplines of forensic science (with its many subspecialties, such as chemistry, entomology, and ballistics) and criminology, a field originating in nineteenth-century psychiatry (p. 4). On the other hand, forensic medicine is not simply a branch of medicine because it grew from, was shaped by, and remains integrally related to the needs and practices of the law. As Watson makes clear, forensic medicine is inherently interdisciplinary.
Chapter 1 traces the emergence of forensic medicine within the two major legal systems in the West, the Continental (based in Roman and canon law) and the Anglo-American (based on the English common law). Differing methods of proof and rules of evidence meant that medical evidence and testimony had differing purposes within in each system. In the inquisitorial procedures of the Continental system, judges conducted investigations of crimes based on written testimony. The search for truth often led them to seek out the opinions of persons not directly involved with the case, such as physicians. Thus the legal system’s need for medical expertise led to the establishment of the formal discipline of forensic medicine housed in institutes and academic departments, the first of which arose in German universities in the seventeenth century. In the English accusatorial system, by contrast, lay juries decided criminal cases. Testimony by medical practitioners (physicians, surgeons, apothecaries, and midwives) might or might not have been included in a proceeding at the discretion of the presiding judge. Thus, a distinct, formal academic discipline of forensic medicine did not initially develop in England, but medical experts nevertheless actively participated in the legal system.
Chapter 2 reaches back to the ancient world to illustrate the wide range of critical duties performed by medical experts “wherever the law and its officers recognized that medical practitioners could be useful to the maintenance of an orderly society” (p. 43). In ancient Rome, for example, physicians were called on to certify that an illness would prevent an individual from fulfilling public office. But throughout Western history, medical expertise has been especially crucial in the realm of criminal justice, where the human body often provides the main--and perhaps the only--source of evidence.
Chapter 3 focuses on the emergence of the modern medico-legal “expert witness” beginning in postrevolutionary France where the state actively supported the professionalization of police work and the standardization of criminal investigation, with toxicology emerging as the first identifiable practice field in forensic medicine. The toxicologist could “render the invisible visible,” offering tangible and invaluable evidence in a courtroom that a poisoning had occurred. Watson argues that the increasing popularity expert witnesses in the court room occurred in tandem with the increasing presence of criminal lawyers, and before long forensic experts acted as “hired guns” for one side in a case rather than as impartial scientific advisers (p. 49). But the growing lucrativeness of forensic medicine also engendered support for its maturation as a scientific field. The world’s first university institute of forensic medicine was founded in 1815 in Vienna, and the field spread rapidly in the decades that followed. Again, Watson tracks carefully how differing structures and requirements of legal systems in Europe, the United Kingdom, and the United States served to shape forensic medicine as a science throughout the nineteenth century.
In the book’s final three chapters, Watson offers relatively brief but fascinating explorations of the complex relationships that exist among law, medicine, and societal attitudes. Chapter 4 focuses on the development of forensic psychiatry and the insanity defense. Chapter 5 examines the medicalization of deviance, particularly suicide, infanticide, and sexual behavior. The concluding chapter highlights twentieth-century developments, such as blood typing, DNA analysis, and offender profiling. Readers may be slightly frustrated by the author’s brevity in these last three chapters, which seem less fully developed than those constituting the first half of the book. Another quibble is the slightly awkward insertion of case studies into the text. While the case studies themselves are extremely interesting and aptly illustrative, they are sectioned off in the physical layout of the page in a way that I found somewhat disruptive; I wish they had been more naturally integrated into the narrative. But these are, indeed, very minor observations on my part. In fact, both of my quibbles actually testify to the strengths of this book, which was written so elegantly that I resented interruptions in my concentration and structured so compellingly that I finished reading wanting to know more.
If there is additional discussion of this review, you may access it through the network, at: https://networks.h-net.org/h-law.
Lynne Curry. Review of Watson, Katherine D., Forensic Medicine in Western Society: A History.
H-Law, H-Net Reviews.
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