Inference in Forensic Pathology
William R. Oliver MD MS MPA
ABSTRACT: Forensic pathologists make inferences about cause and manner of death. Those inferences have come under increasing scrutiny by the courts, by social critics of our findings, and by society at large. Much of this criticism is due to our inability to explain our inferential process. Forensic pathologists should be able to cogently explain the reasoning behind their findings, and express it in terms useful to stakeholders. This requires that we have a basic understanding of different kinds of inference and the scientific method, how they are used and their limitations. Medical diagnosis is not a simple matter of application of cookbook-style inferential laws, but involves a combination of deduction, induction, abduction, dialectic, and informal inference. There are significant differences between the way physicians make inferences compared to how they justify them. A discussion of different kinds of inference, inferential fallacies, evaluation of evidence, causation, and the scientific method is provided, with illustrations from the practice of forensic pathology.