lishing such a system as an extension of the medical examiner and coroner systems.
The study should examine the medical examiner and coroner system for ways to standardize, computerize, and centralize data; examine policies and practices of police investigations of both homicides and suicides to maximize the collection of pertinent data; and make realistic estimates of the costs in time and money to establish such a system.
The development of a fatal intentional injury surveillance system based on the medical examiner and coroner systems would have to address the variability in the completeness, quality, and reporting of death investigations and concerns about the underreporting of certain types of injury deaths in medical examiner reports (Dijkhuis et al., 1994). It would have to develop a centralized data system that would collect all the pertinent information on homicide and suicide cases from the medical examiner's and coroner's reports, information that often remains only in hard-copy form in the medical examiner's or coroner's office.
In an effort to develop as complete a picture as possible of each such event, the proposed system should, at a minimum, include information about (1) the time and place of the incident and of the actual death; (2) characteristics of the injury or wound; (3) characteristics of the victim and, if relevant, the perpetrator(s) and the relationship of the victim to the perpetrator; (4) the motivation and circumstances related to the death; (5) detailed characteristics of the mechanism or weapon; (6) key circumstances related to the death, including the possible role of alcohol and drugs; and (7) details on the location of the injury. Clearly, since much of this information will be supplied to the medical examiner or coroner by the police departments, it is essential that various offices within the Department of Justice and the NIJ participate fully in the development of this system. Unique challenges will be presented in the collection of data for this system, compared to the collection of data about motor vehicle crashes, because some of the desired information, particularly about the perpetrator, motivations, and weapons may not be known in every case.
The committee believes that the development of a fatal intentional injury surveillance system is essential for a nationwide effort in reducing fatal intentional injuries. It will identify common mechanisms and situations resulting in such deaths and will enable researchers to develop preventive interventions. Additionally, it will be a positive step in strengthening the medical examiner and coroner systems, which could ultimately lead to the goal of a comprehensive fatal injury surveillance system.
Although national data are useful in monitoring nationwide trends and evaluating national policies, they are often insufficient for identifying injury patterns or evaluating programs and policies specific to local areas. Indeed, all