Coroner

The coroner is the person who is responsible for the legal investigation of any unexplained or suspicious death occurring within their area of jurisdiction. It is the coroner's job to determine the manner and cause of death. The manner refers to whether the death occurred naturally or by another's hand or by accident. The cause is the medical reason for the death.

The coroner system has a long history in English speaking cultures, with the office existing in England before the tenth century. Indeed, the word coroner comes from the title of the person who crowned the king. Originally, the coroner was not required to have any particular training and many were not even qualified doctors. Coroners were appointed or elected to the position as to any other local political role. In the nineteenth century, when medical education became more formalized, coroners began to be replaced by medical examiners (MEs) in some states, beginning with Massachusetts. The change gathered pace through a series of scandals in New York City where deaths occurring through incompetent anesthesia were not, it was felt, properly investigated. Consequently, the New York administration required that deaths through surgery be examined by a medical practitioner. The ME is medically qualified, although their specialty is not necessarily forensic pathology, or even pathology. Some modern coroners are both lawyers and physicians, although there are still some medically unqualified coroners in rural areas.

Today a coroner who is not medically qualified will consult an ME or forensic pathologist for carrying out autopsies, supervising the forensic laboratory, and testifying in court. The ultimate duties of the coroner include the identification of the deceased in a suspicious death, determination of the time of death (as well as its manner and cause), collection of evidence relevant to the death, and the certifying and signing of the death certificate.

The coroner or ME typically investigates any death that is traumatic, which might have arisen from accident, murder, or suicide. Deaths that are sudden, unusual, or unexpected will also be reported to the coroner. Any death that is unattended by a physician or which occurs within 24 hours of hospital admission or during a medical or surgical procedure will also be reported. Deaths in prison or in police custody are also brought to the coroner's attention. Perhaps a quarter of all deaths will be brought to a coroner's attention each year, although clearly this varies from time to time and from place to place. If there is cause for doubt, then the attending physician will not issue a death certificate, but will refer the matter to the coroner. The remainder of deaths are clearly from natural causes and the doctor can immediately sign the death certificate and release the body for burial or cremation.

Not all of the deaths reported to the coroner will justify an autopsy. The coroner will consult with the person's physician and may decide the death occurred through natural causes if there are no suspicious circumstances and the medical history of the deceased lends support to this view. If either party has any doubt, however, an autopsy and full investigation should be carried out. The rate of autopsy varies. Often a low autopsy rate occurs where it is the practice to have an ME perform an external examination on every corpse referred for investigation, as this measure alone is often sufficient to establish the manner and cause of death.

If the autopsy reveals death by natural causes, and sometimes this can only be determined by an internal examination, then the coroner can sign the death certificate and release the body to the family for burial or cremation. If the death was not by natural causes or if there is some public interest in it, then the coroner will hold an inquest, which is a public inquiry into the death. The inquest is not a trial; it seeks to find out who the victim is, where and when they died and, most difficult, how. There is a specific list of possible verdicts that can form the conclusion of an inquest. These include: unlawful killing, lawful killing, accident, suicide, natural causes, and an open verdict, where there is insufficient evidence to reach any other conclusion. Unlawful killing includes murder as well as manslaughter and death by dangerous driving. If the death is due to criminal activity, such as murder or manslaughter, then the inquest is usually adjourned if the police charge someone with causing the death.