Volume 13, No. 2/2005

Merging Law with Medicine

A stack of file folders leans against the wall in Lisa Schwind’s office, each bundle of paperwork holding a prison inmate’s hopes for freedom.

The files are Delaware’s part of a national effort known as the Innocence Project, which seeks to identify and reopen cases where DNA evidence might clear a person who’s been wrongly convicted of a serious crime.

Schwind, CHNS ’83, is a registered nurse and an attorney who has combined her two areas of expertise to head an unusual, specialized unit in the Delaware Public Defender’s Office. The office’s Forensic Services and Education Unit reviews all major felony cases to determine which ones involve a medical issue that might be useful in preparing a client’s defense at trial, negotiating a guilty plea or affecting the sentence a judge will impose.

Forensics is a term that encompasses the use of scientific information in legal cases. Viewers of the popular CSI: Crime Scene Investigation television series know that medical-forensic investigators study tiny samples of blood, hair and other biological materials found at a crime scene, seeking to develop a theory of what occurred and to match those samples with a suspect.

Schwind says the Innocence Project cases, some involving men who have been incarcerated for many years, are perhaps the most dramatic part of her job. In each case, there’s a possibility that DNA evidence at the crime scene—either overlooked or not able to be processed with the technology in existence at the time—can be used to prove someone was mistakenly convicted. Schwind and her colleagues have screened numerous cases for the possibility of such evidence and have filed motions in 21 of them, asking courts to take another look.

“If you can actually exonerate someone who’s innocent of the crime with which they’ve been charged, you can give them their life back,” Schwind says. “Nothing could be more satisfying than that. But, the Innocence Project cases are just a small part of my job, and the other parts of it are satisfying, too.”

As the forensic services and education coordinator for the statewide Public Defender’s Office, Schwind oversees a unit that also employs another forensic nurse, a paralegal and a recent law school graduate who holds a master’s degree in forensic science. Together, they review cases in which the office’s clients are charged with the most serious crimes, including homicide, sexual assault, first-degree assault and any situation in which DNA evidence might exist. The office represents clients who can’t afford a private attorney.

The goal of the unit, Schwind says, is to assist the trial attorneys by offering insight into relevant medical and scientific issues.

“Most attorneys don’t have a science background, so our unit can help them to fully prepare their case,” she says. “Sometimes, it’s as simple as explaining the pronunciation of medical terms to an attorney, so he or she can do a more effective cross-examination. Other times, it’s as complex as finding an expert witness to testify on a very specific issue.”

In Delaware and nationally, most cases never go before a jury. If Schwind’s review finds evidence indicating that a guilty plea might be the best course of action, she says, she can help explain that to the client and offer the attorney assistance in negotiating an appropriate plea. Medical evidence might be important at the client’s sentencing hearing as well, she says.

She cites some examples of the types of cases where medical evidence plays a role: A client charged with assault has bruises on her throat, bolstering her claim of self-defense; a defendant who suffered head trauma as a child has brain injuries that affect his behavior today; the extent of a victim’s injuries indicates that the legally correct criminal charge is a lesser offense than the one initially filed; hairs found on a baseball cap at a crime scene can be tested for DNA and compared to the defendant’s genetic code.

Schwind is aware that people sometimes view a defense attorney’s work as using technicalities to let the guilty go free, but she says that’s clearly not her job.

“My role is to provide evidence to the defense, which sometimes turns out to be helpful to the defendant and sometimes reinforces the defendant’s guilt,” she says. “The evidence is what it is. We don’t invent it. And, it’s important for the sake of justice that all available evidence is brought out to the court.”

Of cases where she finds evidence that helps to reduce a charge, lessens a sentence or results in a not-guilty verdict, she says, “The work we do provides some checks and balances. Police and prosecutors can make mistakes, and if no one reviews the records correctly, then the defendant hasn’t had adequate representation. That’s not the way our justice system is supposed to work.”

Schwind, who says she relies on the communication skills she developed as a nurse, sometimes is asked to meet with clients to help explain the medical findings in their cases, which often means she’s not delivering good news. Other especially difficult aspects of the job, she says, include reviewing autopsy reports and photos and handling cases in which the victims are children.

“It’s very interesting work, but parts of it are emotionally quite difficult,” Schwind says. “I’d be the first to say that not everyone would want to do this job.”

In fact, Schwind herself never thought she’d be doing it. As a nursing student at UD, she says she never considered law school. After graduation and several years of working in hospitals and for the Delaware Department of Public Health, she became interested in the field and enrolled in Widener University School of Law. Although she hoped to use her medical background when she began practicing law, she says she never expected to specialize in criminal defense.

But, when she interviewed with Delaware Public Defender Larry Sullivan shortly before graduating from law school in 1989, she found that he was looking for an attorney with medical training. “It seemed like a natural fit for me,” she says. She began with a typical caseload of clients and later began assisting her colleagues by conducting medical-forensic reviews of other cases.

Four years ago, a grant from the Delaware Criminal Justice Council enabled the office to create the Forensic Services and Education Unit. Since then, with the growth of DNA refinements and other scientific developments, the demand for medical-forensic specialists has only increased, she says.

“Barry Scheck [the well-known defense attorney who is spearheading the national Innocence Project] says every public defender’s office should have a forensically trained attorney, but our office has taken that a step further with the creation of this unit,” Schwind says. “We believe we’re one of the first units like this in the country.”

Even without a law degree, forensic nurses are in demand, legal experts say. For many years, private attorneys have used them to review medical malpractice and other civil cases. Today, as science advances and more criminal and civil cases rely on DNA and other medical evidence, forensic nurses have more opportunities than ever before, says Schwind, who is president-elect of the new Delaware chapter of the International Association of Forensic Nurses.

In addition, registered nurses can earn a certificate as legal nurse consultants. Both UD and Widener, where Schwind teaches, offer a Legal Nurse Consultant Certificate program. Other forensic specialties for nurses include sexual-assault nurse examiners and, in some states, deputy nurse coroners. But, Schwind notes, even a nurse in a family doctor’s office or a school might encounter a crime victim and be called upon to identify potential legal evidence.

“It would be very helpful for all nurses to have some forensic training, regardless of their discipline,” she says. “That basic knowledge is valuable for all of us.”

—Ann Manser AS ’73, CHEP ’73