Sources of bias in death determination: A research note articulating the need to include systemic sources of biases along with cognitive ones as impacting mortality data

There are structural and organizational factors that impact how and what mortality data are collected. There are individual decision-making processes and implicit cognitive biases that influence how and what mortality data are collected. Yet there seems to be a disconnect between how and why these two broad sources of bias may collide and how both need to be understood in order to be able to approach solutions aimed at strengthening the accuracy of mortality data. Using results from a mixed-method, long-term research project at four medicolegal offices in two countries, France and the United States, this research note proposes that truly understanding the sources of implicit cognitive bias in forensic pathologists and other medicolegal actors requires knowledge of legal, cultural, and organizational structures that shape medicolegal systems and in turn constrain individual actors' decision-making processes. The goal is to advocate for multilevel and multi-methods approaches to propose systemic solutions to the issue of implicit cognitive biases in forensic pathologists and other medicolegal actors' decision-making processes. For this purpose, the author outlines a series of specific issues to be integrated in future research.