Medical Examiner

Differences between Coroners and Medical Examiners

There are two practices of death investigation and examination: the coroner system and the medical examiner system. Both systems originated in Europe, and both coroners and medical examiners are involved with legal inquiry. The type of system used may vary among jurisdictions. Unfortunately, there is still no standardized national system of death investigation in the United States.

In England, during medieval times, the “crowner” was a loyal knight of the realm appointed by the king to investigate untimely, suspicious, and unusual deaths. After the crowner determined whether deaths were natural, accidental, or due to homicide, the findings were reported to the king. Being a political appointee, the crowner (later “coroner”) was not required to have knowledge of, or experience in, forensic science or legal medicine.

Today's coroner is an elected or appointed public official for a specific geographic jurisdiction (city, district, country, or state). The coroner inquires into the death of a person to determine the cause, manner, and mode of death so that the certificate of death may be completed. If deemed necessary, the coroner conducts an inquest to determine the probable cause of the sudden or violent death of an individual and the events that surrounded it. The cause of death may be due to disease, poison, or injury, and the manner of death may have been natural or due to suicide, homicide, accident, or undetermined circumstances. Even today, a coroner is not required to be a pathologist or a medical doctor—or even to have a scientific background in the medical or forensic sciences. In some places, the part-time office of coroner has been occupied by a postman, plumber, teacher, taxi driver, funeral director, or filling station operator (among other medically unqualified individuals). However, a coroner frequently uses the expertise of a specialist by requesting that a physician, pathologist, toxicologist, or forensic pathologist perform laboratory tests or an autopsy to answer any remaining questions concerning the cause and manner of death.

Increasingly, the coroner system is being replaced by the medical examiner system. In sharp contrast to a coroner, the medical examiner, as a licensed physician, is trained in forensic pathology and medico-legal practices. In addition, the medical examiner should be completely independent of political influence. Unlike the coroner, a medical examiner brings specialized expertise to both the professional evaluation of the deceased person's medical history and the scientific examination of a dead body. It is the medical examiner who has the credentials to perform a medico-legal autopsy and to give a professional judgment as to the cause, manner, and mode of death. Medical examiners are also encouraged to take special training in forensic pathology and related medical disciplines to increase their scientific expertise in death investigation and examination.

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