July/Aug 2007

Social Work CSI? — Canadian Social Workers Take on Roles of Community Coroner and Special Investigator
By Valerie Yeager
Social Work Today
Vol. 7 No. 4 P. 30

Popular television shows such as CSI: Crime Scene Investigation and Law & Order portray medical investigations as intriguing, glamorous, and endlessly exciting. Dark, silent corridors dimly lit with flashlights; quick, sharp rhetoric; and an array of handsome men and beautiful women fill every scene. It’s a world away from reality, but social workers in Canada are getting a taste of the intrigue through their involvement in the world of forensic investigation.

Shannon Bender, MSW, RSW, CSW, and Jan Christianson-Wood, MSW, RSW, are Canadian social workers deeply involved in the forensics field as a community coroner and special investigator, respectively. A social work background makes both women qualified to work in which social workers in the United States rarely enter.

A Day in the Life…
As community coroner, Bender is a judicially independent medical-legal investigator who attends the scenes of “unnatural, unexpected, unexplained, and unattended deaths.

“My investigation is complementary to but separate from the police investigation. I take legal possession of the body/remains and assume jurisdiction in the investigation, except in cases of suspected homicide,” explains Bender.

“The coroner is responsible for determining the identity of the deceased and how, when, where, and by what means the death occurred. This includes identifying the medical cause of death, with assistance from pathologists and other professionals when necessary,” she adds. The coroner also offers prevention and public safety recommendations when appropriate.

Because Bender works in a rural area, the number and timing of cases can vary dramatically. She works on an on-call basis, carrying a pager and responding as necessary to a dispatch system where police, physicians, or other hospital personnel contact the answering service and provide initial information. She is then contacted by the service and expected to return a call to the reporting person within 15 minutes and arrive at the scene as soon as possible, depending on the location.

According to Canada’s Coroners Act, no one must interfere with the body or move potential evidence until directed to do so by the coroner following his or her arrival on the scene. For example, if a motor vehicle accident death has been confirmed, the scene cannot be disturbed until Bender has arrived and given direction.

“Once on scene, I conduct an investigation. This always involves an examination of the body and taking photographs. It may also include taking measurements and inspection of vehicles. I have access to medical records, etc., which are always reviewed. I interview witnesses, family members, and medical personnel involved in the care of the deceased person. I may seize any items relevant to the death or inspect any area that may be relevant to the death,” explains Bender.

“Autopsy, toxicology testing, and other analyses are ordered by the coroner, if deemed appropriate. The body of the deceased remains in the legal possession of the coroner until all necessary examinations have been concluded,” she adds.

Although she’s not directly involved with on-site investigations, Christianson-Wood performs similar work as a special investigator (SI) in Manitoba, Canada. Working under the local chief medical examiner, she conducts reviews of child welfare service if the deceased child or his or her parents received service from a mandated child welfare agency in the year preceding the child’s death.

“The intent is to determine if the service provided met the applicable standards and legislation. The function is mandated, and it is not intended to find blame but rather to ensure that services were provided at an acceptable standard. If they are not, I make recommendations to the minister of Family Services and Housing,” says Christianson-Wood.

Although no day is ever typical as an SI, Christianson-Wood describes an “average” day: “In doing case reviews, I work with the staff and management of child welfare agencies. They provide access to the files I review and are interviewed as is necessary. … I also work with members of the provincial child protection branch. During the reviews, I access, when needed, information from medical files, police reports, school files, youth correctional facilities, and youth care facilities. I always have the option of conducting interviews whenever warranted.”

Education
The position of coroner is often assumed to be held by someone with a highly specialized medical degree and a background in law, but that isn’t always the case. A background in social work and a career in forensics—as Bender and Christianson-Wood demonstrate—may be an ideal blend of disciplines.

With her master’s degree in social work and specialization in trauma, Bender is qualified to take on the role of community coroner for the British Columbia coroners service. Her massage training, background in anatomy and physiology, and additional on-the-job training are a big plus, and consultation with other experts is always available.

Because the educational prerequisites to become coroner vary from province to province in Canada, the background of employees varies widely. “All provinces in Canada use different models. British Columbia uses a model that does not require one to possess a medical degree. A combination of relevant backgrounds means we have a service with professionals who have a variety of expertise. We are then able to draw on each other,” says Bender.

To qualify for her position as a community coroner in British Columbia, Bender underwent an application, interview, and testing process. “Once selected, one has to be a coroner’s agent [work under the guidance of a coroner] for one year to train and to prove ability. At that time, if successful, one receives an ‘order in council.’ This is basically a formal appointment to the position through our legislature [the provincial government],” explains Bender. The process is quite different from the United States, where coroners are elected officials to the state or county government.

Although Christianson-Wood also doesn’t have formal medical training, she has, over the years, learned a fair amount about medical conditions affecting children, especially those with the potential to end the child’s life. Nevertheless, her social work background is crucial to her professional success.

“The qualifications that I must have for my job are related to social work. I have a master’s degree in social work [in addition to bachelor’s degrees in psychology and social work] and am a registered social worker in the province of Manitoba,” says Christianson-Wood.

Her background in child welfare casework and as a researcher and project manager for a university research group investigating risk estimation in child welfare practice have blended well with the forensics field. Her master’s thesis was written on predicting fatal child maltreatment, and she has also cowritten a report on the state of child death review in Canada and consulted on deaths of children associated with child welfare systems outside Manitoba.

Homicides
As one would imagine, every day is unique in the life of a coroner or special investigator, although—despite what popular television shows often want us to believe—every case isn’t a homicide.

Relatively few cases in Bender’s rural region are the result of a homicide but, as expected, this varies with the region. Urban areas with a high population will have a greater variety of cases—and more homicides. In any circumstance, “in homicide cases, the police take a primary role while the coroner assumes a secondary role. The agencies work closely together to ensure that the case is not compromised,” says Bender.

Christianson-Wood explains that homicides are treated as priorities, and she must be careful about how much information is included about the actual death since the cases are under police investigation while her review is conducted.

She and her fellow SI, also a social worker, take on an average of 40 to 45 new cases for review each year, and the number of homicides varies, with eight being the highest she can recall. This is not necessarily the total number of child homicides during the year in Manitoba, but rather the number where the family was associated with child welfare at any point in the year prior to the child’s death.

Unfortunately, the law doesn’t allow Bender or Christianson-Wood to elaborate on specific cases.

Complex and Challenging
“All cases are interesting, as no two are ever exactly the same. Sometimes a case can be challenging simply because the remains have been there so long that determining an identity and an exact cause of death can be difficult. Others are very challenging because of the personalities of the family members and professionals involved,” says Bender.

“Some very interesting cases come from situations where a piece of medical equipment is suspected of having malfunctioned. Another interesting case was one where the scene initially appeared to be that of a homicide but was eventually determined to be a suicide,” Bender continues.

Forensic social work is a valuable area of specialization in the United States, but it has yet to utilize social workers in the unique way that Canada is involving them in investigations of mortalities. Application of social work skill sets in these types of investigations may offer resources untapped by coroners and medical examiners in this country.

— Valerie Yeager is an editor and freelance writer based in Philadelphia.

Coroner vs. Medical Examiner
In the United States, there’s often confusion between the terms coroner and medical examiner. While the associated roles are similar, they require different educational prerequisites, and a coroner is typically an elected position whereas a medical examiner is appointed.

The official definition of a coroner is generally accepted to be “an elected public officer whose principal duty is to inquire by an inquest into the cause of any death which there is reason to suppose is not due to natural causes” (Merriam-Webster Online).

The technical definition for medical investigator is “a public officer who conducts autopsies on bodies to find the cause of death” (Merriam-Webster Online).

While a coroner may have a medical degree, it’s not typically required. In both Canada and the United States, a medical examiner must be a physician with specialization in pathology or forensic medicine. In some jurisdictions, a medical examiner must be both a doctor and a lawyer. For instance, The Virginia Institute of Forensic Science and Medicine only accepts trainees who already have both medical and law degrees.

— VY

Child welfare mortalities patterns and prevention
Although coroners and special investigators must remain silent on specific cases, Jan Christianson-Wood, MSW, RSW, notes the fact that reviews are completed is generally known by the public. She mentions the case of the late Phoenix Sinclair, a child who was missing for months and believed to have been murdered. The case is still under investigation but was well covered in the media. Christianson-Wood’s office reviewed the services provided to Phoenix prior to her death.

A foster child most of her life, Phoenix had been returned to the custody of her birth mother, who is now being charged with first-degree murder in the case. The child was missing for nine months before anyone reported her absence. After police charged the suspect with murder, Manitoba launched two reviews into the province’s child welfare system this past March.

The case has raised serious concerns about the child welfare system, as three children have died while in the care of Child and Family Services agencies in the past year. Another six children who died last year had received assistance from Child and Family Services in the past. Special investigators like Christianson-Wood will research these cases, developing a report to determine whether any patterns are occurring and how to avoid them.

— VY