It is a truism in the field of surgery (and perhaps medicine in general) that the greater the number of treatment options available for a given condition, the less likely it is that any single one of them represents the definitive solution. Similar sentiments might be said to apply to the mechanisms employed in estimating the post mortem interval. In this area, as with many aspects of forensic pathology, current practice and enlightened progression are dictated (and not infrequently fettered) by received wisdom, often with little more substantive basis than intuition. This valuable book, now in its second edition, does much to address these inadequacies by offering an in-depth analysis and empirical underpinning to a problematic and important area of forensic practice.
In many cases, accurate timing of death is of minor significance in the investigation and outcome of criminal investigations; but to what extent this is informed by resignation and frustration at the imprecision of the current methods is difficult to say. More often in the author's experience analysis of rigor, lividity, circumstances and witness statements provide the necessary information, and ancillary quantitative methods (such as temperature estimations) are relegated to the corroborative. The issue seems to arise most commonly during coroner's inquests where concerned parties raise the question of timing of death, often with the subtext that 'something' might have been done 'sooner'.
In the preface to this second edition of The Estimation of the Time Since Death in the Early Postmortem Period, Professor Knight comments that 'there has been relatively little original research published in the field of death-time estimation in the years since the first book appeared (1995)' and this may go some way to explaining why much of the text reappears, unchanged, from the first edition. Nevertheless, the monographs in this book represent an impressive distillation of the painstaking and complicated research towards attaining the Holy Grail of pathology. Many will be (understandably) tempted when confronted with this imposing mass of data to heed Professor Knight's advice in the preface to the first addition, and proceed to 'the more practical sections, which summarise the best current methods', but this would be doing the book a disservice. There is much to be gained here from a leisurely perusal of the methodologies, complexities, caveats and conclusions.
So how far have we advanced since the first edition was published? Well the short answer is 'a distressingly short distance', although the book contains many useful references, as well as ideas and exhortations for further research. In day-to-day practice, many of the methods described are simply too complicated, imprecise and (ironically) time consuming. Myographical methods for instance are likely to be beyond the scope of most practitioners not least because the equipment is not widely available. The discussion and debunking of gastric content analysis as a method for the timing of death is as timely as it is salutary, and is gratifyingly reinforced by an account of the Steven Truscott case.
The utility of temperature measurements is justifiably discussed in some considerable detail (particularly given its prominence in the Summary and practical scheme for casework) with welcome advice on how to deal with the numerous variables that may conspire to confound the accuracy of the results obtained. And a particularly interesting, but unfortunately comparatively brief, discussion on the use of outer ear temperatures is included for the first time, but would have benefited from the addition of a 'user's guide' to the different instruments available for the purpose. Relatively cheap, portable devices are available on the high street and are commonly employed in emergency departments, but are they as dependable and accurate as thermocouple probes?
The disappointing scientific advances in this important area of forensic practice are reflected in the many similarities between this book and its first edition. However, the many worthwhile additions and expanded discussions in this unique and authoritative work, along with a wealth of recent references, will make it an indispensable volume in the library of forensic practitioners.
