RT Book, Section A1 Middleberg, Robert A. A2 Nelson, Lewis S. A2 Howland, Mary Ann A2 Lewin, Neal A. A2 Smith, Silas W. A2 Goldfrank, Lewis R. A2 Hoffman, Robert S. SR Print(0) ID 1163005886 T1 Medicolegal Interpretive Toxicology T2 Goldfrank's Toxicologic Emergencies, 11e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9781259859618 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1163005886 RD 2024/03/29 AB One of the potential areas of collaboration for toxicologists is the medicolegal setting. This includes working with forensic toxicologists, medical examiners, law enforcement, lawyers, and regulators. In this arena, interpretive toxicology, whether based on analytical findings or theoretical concepts, is routinely used or required to explain issues in criminal and civil proceedings and as the basis for policy making. Often, the concepts associated with forensic interpretive toxicology are presumed to be associated with deceased individuals. In practice, the preponderance of cases involving toxicologic interpretation involves living people and includes specialty testing such as human performance toxicology. Regardless, interpreting the role, or potential role, of xenobiotics in an adverse outcome is typically not straightforward. For example, the use of generally applied pharmacokinetic equations is usually inappropriate, especially in the postmortem setting, yet it is in widespread practice by individuals unfamiliar with the nuances of case-related issues.27 Rarely is any given case accurately interpreted solely based on toxicologic assessment. As such, forensic interpretive toxicology generally involves an integrative approach that draws on an understanding of case history in addition to analytical, toxicologic, pathophysiologic, and specimen-related issues. Individuals called on to interpret the role of xenobiotics in any given case must understand the factors that affect such interpretations and associated limitations. Furthermore, although difficult in many situations, they should attempt to have their opinions firmly supported by science. Other chapters in this text (Chaps. 7, 41 and 140, Special Considerations: SC11 and SC12) cover much of the basic science associated with interpretive issues. This section is meant to focus on specific issues as they relate to medicolegal (forensic) interpretive toxicology.