In both the United States and Western Europe in the mid-nineteenth century, forensic physicians engaged in bitter jurisdictional disputes with members of well-established legal professions, within the context of long-standing judicial institutions. In Russia, by contrast, the emergent medical and legal professions—both critical of the autocracy and state institutions in which they worked—joined forces in their attempts to fundamentally transform the autocratic system and its judicial institutions, based on claims of technical and professional expertise. As such, the development of forensic-medical expertise took a path that differed from the Western model. In Russia, forensic physicians reacted to and influenced the evolution of bureaucratic state structures. Consequently, medical professionals sought to increase—rather than minimize—their role within the state's legal system in order to transform an otherwise arbitrary judicial process along the lines of “scientific rationality” and “objectivity.”