examining the body, determining whether to perform an autopsy, and ordering x-ray, toxicology, or other laboratory tests. There are broad differences between medical examiners and coroners in training and skills and in the configuration of state and local organizations that support them. Medical examiners are physicians, pathologists, or forensic pathologists with jurisdiction over a county, district, or state. They bring medical expertise to the evaluation of the medical history and physical examination of the deceased. A coroner is an elected or appointed official who usually serves a single county and often is not required to be a physician or to have medical training. The evolution of today’s diverse death investigation system traces back to medieval England.

Historical Origins

Coroners date back to 9th and 10th century England. They were formalized into law in the 12th century under King Richard I (Richard the Lion-Hearted). The king dispatched coroners to death scenes to protect the crown’s interest and collect duties (coroner is derived from Anglo-Norman corouner, the “guardian of the crown’s pleas”). Coroner laws were imported into the colonies with the early colonists. For example, the British Colony of Georgia followed British Common Law in 1733; the first state constitution mentioned coroners; and subsequent statutes described coroner duties. The first move toward reliance on a medical examiner took place in 1860 with the passage of Maryland legislation requiring the presence of a physician at the death inquest. Thus, the role of the coroner and medical examiner evolved from a highly decentralized system rooted in local or county ordinances. With awareness of the need for expertise in death investigations, there has been a nationwide trend, since 1877, to replace coroners with medical examiners, but efforts have been stalled since the middle 1980's (Hanzlick and Combs, 1998).

Current Distribution of Coroner and Medical Examiner Systems

Today, 11 states have coroner-only systems, wherein each county in the state is served by a coroner. Another 22 states have medical examiner systems, most of which are statewide and are administered by state agencies. And 18 states have mixed systems: some counties are served by coroners, others by medical examiners,



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