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
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