Medical Examiners: From Coroners to Modern Forensics

Introduction and Purpose

The purpose of this paper is to introduce, discuss, and analyze the topic of medical examination. Specifically, it compares the medical examiners of years past to the current technological advancements of medical examiners today. The earliest medical examiners were called coroners, and they still exist in some areas of the United States, although they have largely been replaced by medical examiners. Medical examiners are licensed physicians trained in pathology and death investigation.

The Coroner System: Origins and Flaws

In the past, coroners had much more power than they do today. They were more involved in criminal justice and could even arrest prisoners and set their bail. They were not paid a salary but were paid for each inquest they conducted. This payment structure opened them to bribes and embezzlement, since they did not receive regular compensation. Families would offer bribes to cover up suicides, and politicians would offer bribes to cover up embarrassing accidents or other deaths that might impact their political careers.

The corruption was widespread and acknowledged by those in the system. One New York City coroner stated, "A few of the coroners, and let me emphasize that it were only a few, were outrageous crooks who dispensed 'justice' for cash. Their only interest in each new case was to discover how they could extort money, and they used the power of their office for blackmail purposes" (Timmermans).

In many rural areas, the coroner was actually the sheriff, who had little medical knowledge or training and often just guessed at the cause of death. Even today in some areas, coroners can be anyone, from a tow-truck driver to a funeral director, and everything in between. They conduct inquests and can call in a jury of citizens to determine the cause of death. Without advanced tools and formal training, their determinations were often wrong or at least flawed.

Modern Medical Examiners: Training and Standards

Most medical examiners today are very different from the coroners of the past. Most are trained physicians who have additional training in death investigation and forensics. Forensic pathology represents a significant professionalization of the field. According to Stefan Timmermans, "All states with medical examiners require them to be physicians, and most demand additional certification in anatomical and forensic pathology" (Timmermans).

It is important to note that only 22 states have a full medical examiner contingent in every county, and 11 states still use the coroner system. Today, medical examiners do not use a jury or inquest. Instead, they rely on training and expertise to make determinations about cause of death. They use technology that was unavailable just a few decades ago, such as forensic technologies in ballistics, scientific investigation, computer investigation, and crime scene investigation. Many of the techniques available to today's medical examiners were not even possible a few decades ago, and they play a much more important role in crime scene investigation than ever before.

Conclusion

The evolution from the coroner system to the modern medical examiner office represents a fundamental shift in how death investigation is conducted in America. Through professionalization, standardized training, and access to sophisticated forensic technology, medical examiners have transformed death investigation from a potentially corrupt, amateur enterprise into a rigorous scientific discipline. While some jurisdictions still retain coroner systems, the trajectory is clear: modern death investigation is characterized by expertise, accountability, and technological sophistication.