TABLE OF CONTENTS INTRODUCTION I. TRACKING EMERGING PRACTICES A. Clinical Podiatry B. "Forensic Podiatry" C. Forensic Gait Analysis (and Gait Analysis) D. An Emerging Practice II. EVIDENTIARY FOOTING: IN THE COMPANY OF PRE-SCIENTIFIC COMPARISON FORENSICS A. Feet of Clay: Forensic Podiatry's Standards of "Scientific Practice" B. Sound Footing: The Minimum Requirements for Forensic Sciences C. Learn to Crawl Before You Can ...: The Evidence Base for Forensic Gait Analysis D. Foot in Mouth: Expressions and Conclusions III. FANCY FOOTWORK: DEMARCATING FORENSIC PODIATRY A. Beyond Chiropody: Positioning Forensic Podiatry in Relation to Podiatry B. Treading on Toes: Avoiding Trespassing into Existing Forensic Domains C. Side-Stepping Technoscientific Approaches: Relations with Biometrics D. Best Foot Forward: Securing Public Recognition IV. FOOT FETISH: LAW AND THE CO-PRODUCTION OF EXPERTISE, IDENTITY AND GUILT UNHAPPY FEET: IS THERE SUCH A THING AS FORENSIC PODIATRY? INTRODUCTION
This article describes and problematizes the field of forensic podiatry, and in particular the emerging practice of forensic gait analysis. (1) It is our intention to explain how forensic podiatry came into being, shed light on forensic science field formation, make an assessment of forensic podiatry and its knowledge base, and reflect on what the emergence of forensic podiatry and judicial acceptance of forensic gait analysis reveal about the legal recognition and legitimation of expertise in common law criminal justice systems. Forensic podiatry has been promoted as one of the most recent additions to the forensic sciences. (2) Using forensic gait analysis, podiatrists claim to be capable of addressing a conspicuous evidentiary gap confronting the rapidly increasing range of images and videos associated with criminal acts, namely the identification of persons of interest (POI) in recorded images where other forensic methods (such as face and body mapping) cannot assist. (3) Through the analysis of movement (or gait) and posture, podiatrists have insinuated that they are specially situated to assist with the problem of identity. (4)
Our analysis directs attention to the admissibility and probative value of evidence derived through forensic gait analysis. For the purpose of evaluating this "evidence," we draw upon recommendations by the United States National Academy of Sciences (NAS) and the United States National Institute of Standards and Technology (NIST) as benchmarks against which the performance and abilities of podiatrists, lawyers, and judges might be profitably explored. (5)
TRACKING EMERGING PRACTICES
In order to understand the advent of forensic podiatry and the legal recognition of forensic gait analysis, it is useful to take a small step back to introduce, respectively, clinical podiatry and forensic podiatry. Clinical podiatry is the domain where most podiatrists operate and from which interest in forensics emerged. (6) Most podiatrists, including so-called forensic podiatrists, practice primarily as clinical podiatrists. (7)
Clinical podiatrists "diagnose and treat conditions of the foot, ankle, and related structures of the leg." (8) In the United Kingdom (U.K.), they are regulated by the Health and Care Professions Council (HCPC). (9) The HCPC publishes standards of proficiency. (10) These standards require podiatrists to operate within the legal and ethical boundaries of their profession. (11) They also require podiatrists to "be able to engage in evidence-based practice." (12) Familiarity with relevant research (i.e. specialized knowledge) and scientific processes is a formal requirement of continuing registration. (13). Podiatrists are expected to "be aware of the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process." (14)
In the United States, podiatry is regulated on a state-by-state basis. (15)" By way of example, New York regulates podiatrists and chiropodists under Article 141 of the Education Law and the Regulations of the Commissioner of Education. (16) To practice podiatry, an individual must complete a four-year Doctor of Podiatric Medicine program that complies with the Department of Education's standards, and pass an examination administered by the National Board of Podiatric Medical Examiners (NBPME). (17) The NBPME website explains that the exam is developed in accordance with the Standards for Educational and Psychological Testing. (18) The criteria for test development and the principles set out in the Education Law and subsequent regulations do not refer to evidence-based practice. (19) Nevertheless, an article published in 2005 in the Journal of the American Podiatric Medical Association reported on endeavors to integrate evidence-based approaches into the curriculum at training institutions. (20) In another article published in the same journal within the decade, it was said that podiatrists receive an education that is "virtually equal to that of medical and surgical specialists who hold an unrestricted medical license." (21)
Regulation and standardization are intended to position podiatry firmly within the biomedical mainstream. (22) However, unlike practice rules promulgated by most medical specialties, the standards promoted by the Health and Care Professions Council for podiatrists in the U.K. contemplate the possibility of derogation.
Your particular scope of practice may mean that you are unable to continue to demonstrate that you meet all of the standards that apply for the whole of your profession. As long as you make sure that you are practising safely and effectively within your given scope of practice and do not practise in the areas where you are not proficient to do so, this will not be a problem. If you want to move outside of your scope of practice, you should be certain that you are capable of working lawfully, safely and effectively. This means that you need to exercise personal judgement by undertaking any necessary training or gaining experience, before moving into a new area of practice. (23) According to these standards, provided podiatrists appropriately restrict the scope of their practice, this represents an acceptable compromise for specialization. It would appear to be a tenet of their nascent professionalization and a condition of recognition from the biomedical mainstream that podiatrists are conversant with their limitations and only practice in areas where they are demonstrably proficient. (24)
The College of Podiatry represents podiatrists and chiropodists in the U.K. (25) It espouses a commitment to evidence-based practice: "We promote guidelines and standards of practice that are evidence based, ensuring patient safety and clinical effectiveness with a focus on outcomes." (26) In furthering this commitment, the College of Podiatry purports to develop policies with "the support of the U.K.'s most prominent podiatrists, scientists, and researchers." (27) The United States equivalent is the American Podiatric Medicine Association (APMA). (28) In short, both regulators (such as the HCPC) and leading representative bodies hold podiatry out as a modern field of healthcare." (29) In recent years, a conspicuous emphasis has been placed on evidence-based standards and practice. (30) As one might expect, the HCPC, the College of Podiatry, and APMA are primarily oriented toward certification, patient-podiatrist relationships, and the regulation of clinical practice. (31) Their standards and policies do not expressly consider forensic work, forensically-oriented techniques, or the special responsibilities of podiatrists acting as expert witnesses in criminal investigation and prosecutions-i.e., so-called forensic podiatry. (32)
In conjunction with regulatory arrangements and the pronouncements of professional bodies, podiatrists have historically emphasized their independence from other health, medical, and therapeutic fields. (33) One definition advanced by exponents of research-based podiatry captures both the focus and the division of responsibility: "Podiatry exists as a clinically independent profession involving the diagnosis and treatment of the whole foot independently of medical practitioners." (34)
As in many paramedical fields, the organization and regulation of podiatry appears to be driven by two--occasionally conflicting--motivations. On one hand, the drive for professional status, biomedical recognition, and access to healthcare funding (and insurance cover) has prompted leaders and regulators to impose professional standards that parallel (or perhaps mimic) those of medicine in terms of training, scientific rigor, and ethical precepts. (35) On the other hand, the desire to maintain autonomy, in part through differentiation, has led podiatrists to distinguish podiatry from medicine and other cognate fields while maintaining, and perhaps extending, the scope of their practice. (36)
Acting on these professional motivations, clinical podiatry has sought to transform itself from technical certification (and the work of "filing and clipping" historically associated with chiropody) into a degree-based clinical practice that includes surgical intervention, albeit tightly circumscribed. (37) Seeking to promote both the need for a conspicuous evidence base for podiatry and greater methodological sophistication among podiatrists, university-based podiatrists Vernon and Campbell wrote:
We are constantly told that, as podiatrists, we need to research, but what does this really mean? This question can be particularly problematic in a profession such as podiatry, where there has not been a strong research basis for our practice in the past, where podiatrists were trained by simply being presented with information as the knowledge required to be able to practise. (38) Simple rhetoric or anecdotally based arguments are no longer adequate when attempting to justify a...