Modern American Death Investigation Systems

As will be seen subsequently, the systems of death investigation in the United

States are widely varied. However, they generally share a number of mission

components in common. To paraphrase DiMaio and DiMaio,21 the various

components of a death investigation system are as follows:

1. Determine the cause of death, and how the death came about

2. Identify the decedent

3. Determine the time of death and injury

4. Collect evidence from the body that may be useful in the police

investigation

5. Document injuries that are present, or their absence

6. Deduce how injuries occurred

7. Document any natural disease present

8. Document or exclude any causative or contributory factors in the death

9. Provide testimony in court as needed

In spite of the widespread distribution and long history of the office of

the coroner, as medical science and the understanding of death have become

more complex, shortcomings of the system have became apparent. Most

obvious is the fact that most coroner jurisdictions do not require a coroner

to be a physician. Obviously, a nonphysician is in a poor position to render

a medical opinion on the cause of death, a determination that is manifestly

the practice of medicine. The likelihood of omissions or misinterpretations is

increased in such jurisdictions where the responsibility for this duty is vested

in someone other than a trained physician. Second, coroners are elected

officials in the United States. The necessity of maintaining public electoral

support has long been considered a potential impediment to the development

and maintenance of absolute impartiality in death investigation by coroners.

Death investigators must often make very hard and controversial decisions

that are difficult for families, local political forces, and others to accept. In

theory, at least, an appointed official, as opposed to an elected one, can make

such decisions without the fear of alienating a voting block necessary for his

or her continued employment in the position.

Proponents of the coroner system respond that the nonmedical coroner

functions as an administrator and quasi-judicial agent, and can employ physicians

to perform examinations and make medical decisions under his or

her directions. However, since the coroner retains ultimate authority for the

investigation and determination of the circumstances and cause of death,

the possibility that such an individual will exercise that authority to veto or

influence the medical decision of an employed physician still remains. Some

coroner proponents also point to the greater political authority of an elected

death investigation systems