The medical examiner is an official in some American Jurisdiction[ who is trained in pathology and investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate .]
In the US, there are two death investigation systems: first, the coroner system based on English law; and second, the medical examiner system, which evolved from the coroner system during the latter half of the 19th century. The type of system varies across jurisdictions, with over 2,000 separate jurisdictions for investigating unnatural deaths. In 2002, 22 states had a medical examiner system, 11 states had a coroner system, and 18 states had a mixed system. Since the 1940s, the medical examiner system has gradually replaced the coroner system and serves about 48% of the US population.
The coroner is not necessarily a Physician. They may be a lawyer or a layperson. In the 19th century, the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician. In 1918, New York City introduced the office of the Chief Medical Examiner and appointed physicians experienced in the field of pathology. In 1959, the medical subspecialty of forensic pathology was formally certified.
The types of death reportable to the system are determined by federal, state, or local laws. Commonly, these include violent, suspicious, sudden, and unexpected deaths, death when no physician or practitioner was present or treating the decedent, inmates in public institutions, those in custody of law enforcement, deaths during or immediately following Therapy or Diagnosis procedures or deaths due to neglect.
Duties
A medical examiner's duties vary by location, but typically include:
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investigating human organs like the stomach, liver, and brain
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determining cause of death
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examining the condition of the body
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studying tissue, organs, cells, and bodily fluids
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issuing death certificates
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maintaining death records
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responding to deaths in mass disasters
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working closely with law enforcement
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identifying unknown dead
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performing other functions depending on local law.
In some jurisdictions, a coroner performs these and other duties. It is common for a medical examiner to visit or to testify in court.
Within the United States, there is a mixture of coroner and medical examiner systems, and in some states, dual systems. The requirements to hold office vary widely between jurisdictions.
Qualifications
United Kingdom
In England and Wales, a new statutory Medical Examiner system based in NHS Acute Trusts commenced in 2019 and is expected to be fully operational several years later. A medical examiner is always a medical doctor, whereas a coroner is a judicial officer.
Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death".
United States
Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction. In Wisconsin, for example, some counties do not require individuals to have any special educational or medical training to hold this office.[Coroners and Medical Examiners: A Comparison of Options Offered by Both Systems in Wisconsin Jenifer Keach, Rock (WI) County Coroner, April 6, 2010] In most jurisdictions, a medical examiner is required to have a medical degree, although in many there is no requirement for specialized training in pathology. Other jurisdictions have stricter requirements, including additional education in pathology, law, and forensic pathology. Medical examiners are typically appointed officers.
Education
In the United States, medical examiners require extensive training in order to become experts in their field.
To become experts in pathology, specifically, additional training is required after medical school. The first step is to complete pathological forensic training.
Career
The general job outlook for medical examiners in the United States is considered to be excellent.
Shortage
In the United States, there are fewer than 500 board-certified forensic pathologists, but the National Commission on Forensic Science estimates the country needs 1,100–1,200 to perform the needed number of autopsies. The shortage is attributed to the nature of the work and the higher pay in other medical specialties. It has caused long delays in some states and resulted in fewer investigations and less thorough investigations in some cases.
See also
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Coroner
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List of fictional medical examiners
Further reading
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See also the links at the bottom of the linked article.
