CORONERS AND MES THE CORONER SYSTEM
The office of coroner was first granted by England’s “Charts of Privileges” to St. John of Beverley in AD 925, and before the 1194 publication of the “Articles of Eyre,” the office of coroner had become an official position throughout the country. These individuals were called “keepers of the pleas of the crown,” a phrase later shortened to “crowner” and then “coroner.” The position was initially that of a formidable and prestigious judicial officer in charge of collecting monies due to the king, trying felony cases, and gradually narrowed to the investigation of unusual, untimely, or suspicious deaths. By the thirteenth century, coroners had to examine all bodies before burial and appraise all wounds, bruises, and other signs of possible foul play (Thorwald, 1964) (see “History: The Origins of the Coroner System”).
The first American coroner was Thomas Baldridge of St. Mary’s, Maryland Colony appointed on 29 January 1637. He held his first death inquest two days later. It was not until 1890 that Baltimore appointed two physicians as the United States’ first MEs (Thorwald, 1964). The position of coroner can be appointed or elected, and typically no formal education or medical training is required. Today, many coroners are funeral directors, who get possession of the body after the autopsy. This can be a major source of income to such officials. A medical examiner, in contrast, is typically a physician who has gone through four years of university, four years of medical school, four years of basic pathology training (residency), and an additional one to two years of special training in forensic pathology. These positions are appointed. Some states’ have a mixture of MEs and coroner systems whereas others are strictly ME or coroner systems (see Figure 1):
The beginning and end of life are socially bounded by a certification process on which major monetary and legal issues often turn. Any licensed physician is permitted and expected to sign death certificates in cases of natural death of patients which that physician is treating. Unlike the mosaic of ME and coroner systems, there is a United States Standard Certificate of Death on which all 50 states closely base their individual death certificates. Additionally, some printed guidelines exist to assist physicians in the completion of this form, which is not necessarily straightforward, even for natural deaths (Council of American Pathologists, 2006).
FIGURE 7.1 Map of coroner and ME systems in the United States.
