coroner

Duties and functions

Responsibilities of the coroner may include overseeing the investigation and certification of deaths related to mass disasters that occur within the coroner's jurisdiction. A coroner's office typically maintains death records of those who have died within the coroner's jurisdiction.

The additional roles that a coroner may oversee in judicial investigations may be subject to the attainment of suitable legal and medical qualifications. The qualifications required of a coroner vary significantly between jurisdictions and are described below under the entry for each jurisdiction. Coroners, medical examiners and forensic pathologists are different professions. They have different roles and responsibilities.

Etymology and history

The office of coroner originated in medieval England, first constituted in the reign of Richard I, and has since been adopted in many other countries whose legal systems have their roots in English or United Kingdom law.

In September 1194, the king's itinerant justices in Eyre were required to ensure that in each county of England three knights and a clerk were elected to serve as 'keepers of the pleas of the crown' (custodes placitorum coronae, from whence the word "coroner"). The duties with which the office was entrusted, and which were involved in 'keeping' the crown pleas—which included holding inquests upon dead bodies found within his jurisdiction, hearing the confessions and appeals of felons, and receiving abjurations of the realm made by felons who had taken sanctuary—were not new in 1194. Many of them had previously been performed by a range of local officials, such as the county justiciar (an office in place under Kings Henry I and Stephen), or the serjeant or bailiff of the hundred. For a few decades after the institution of the office of coroner, however, his precise duties were often unclear, and there remained a degree of power-sharing with these officials: the serjeants continued to perform valid inquests on dead bodies and sometimes hear appeals and confessions as late as 1225, despite a plea of the barons to King John in 1215 that 'no sheriff concern himself with pleas of the crown without the coroners'.

"Keeping the pleas" was an administrative task, while "holding the pleas" was a judicial one that was not assigned to the locally resident coroner but left to judges who traveled around the country holding assize courts. The role of custos rotulorum or keeper of the county records became an independent office, which after 1836 was held by the lord-lieutenant of each county.

The person who found a body from a death thought sudden or unnatural was required to raise the "hue and cry" and to notify the coroner. While coronial manuals written for sheriffs, bailiffs, justices of the peace and coroners were published in the sixteenth and seventeenth centuries, handbooks specifically written for coroners were distributed in England in the eighteenth century.

Coroners were introduced into Wales following its military conquest by Edward I of England in 1282 through the Statute of Rhuddlan in 1284.

By region

Australia

Australian coroners are responsible for investigating and determining the cause of death for those cases reported to them. In all states and territories, a coroner is a magistrate with legal training, and is attached to a local court. Five states – New South Wales, Queensland, South Australia, Victoria and Western Australia – also have state coroners and specialised coronial courts. In Tasmania, the Chief Magistrate also acts as the state coroner.

Brazil

In Brazil, coroner work is done by Médicos-Legistas (Lawful Physicians), that are police officers and forensic experts with degrees in medicine.

In the Department of Federal Police, the Médicos-Legistas work on highly complex federal crimes involving corpses that need to be examined by the Forensic Medicine and Dentistry Sector linked to the National Institute of Criminalistics.

Throughout the federative units, the Civil Polices (in Federal District and other 8 States) or Scientific Polices (in all other 18 States) disposes of their own Legal-Medical Institutes (mainly responsible for confirming the authorship, dynamics and materiality of offenses involving living beings or their respective corpses) and, with the exception of Paraná, the Médicos-Legistas constitute a police career of their own.

Canada

According to Statistics Canada,

Death investigation is the responsibility of each individual Canadian province and territory—there is no overarching federal authority. As a result, each province and territory has developed its own system and legislation to fulfill the mandate of investigating deaths that are unexpected, unexplained, or as a result of injuries or drugs. Two different death investigation systems have developed in Canada: the Coroner's system and the Medical Examiner's system. The Coroner's system is used in the majority of provinces and territories. It is a system that is centuries old and originated in Great Britain. It is found throughout the world in countries that were former British colonies, including Canada. The Medical Examiner's system (used in Alberta, Manitoba, Nova Scotia, and Newfoundland and Labrador) is just over one century old and originated in the United States. Although there are some differences between the two systems, the ultimate goal of each is the same—to investigate certain deaths defined in their legislation and establish the identity of the deceased together with the cause of death and the manner of death.

In 21st-century Canada the officer responsible for investigating all unnatural and natural unexpected, unexplained, or unattended deaths goes under the title "coroner" or "medical examiner" depending on location. They do not determine civil or criminal responsibility, but instead make and offer recommendations to improve public safety and prevention of death in similar circumstances.

Coroner or Medical Examiner services are under the jurisdiction of provincial or territorial governments, and in modern Canada generally operate within the public safety and security or justice portfolio. These services are headed by a Chief Coroner (or Chief Medical Examiner) and comprise coroners or medical examiners appointed by the executive council.

The provinces of Alberta, Manitoba, Nova Scotia and Newfoundland and Labrador now have a Medical Examiner system, meaning that all death investigations are conducted by specialist physicians trained in Forensic Pathology, with the assistance of other medical and law enforcement personnel. All other provinces run on a coroner system. In Prince Edward Island, and Ontario, all coroners are, by law, physicians.

In the other provinces and territories with a coroner system, namely British Columbia, Saskatchewan, Quebec, New Brunswick, Northwest Territories, Nunavut, and Yukon, coroners are not necessarily physicians but generally have legal, medical, or investigative backgrounds.

Hong Kong

The Coroner's Court is responsible to inquire into the causes and circumstances of some deaths. The Coroner is a judicial officer who has the power to:

Grant:

Burial orders

Cremation orders

Waivers of autopsy

Autopsy orders

Exhumation orders

Orders to remove dead bodies outside Hong Kong

Order police investigations of death

Order inquests

Approve removal and use of body parts of the dead body

Issue certificates of fact of death

The Coroner makes orders after considering the pathologist's report.

Ireland

The Coroners Service is a network of Coroners working across Ireland, usually covering areas based on Ireland's traditional counties. They are appointed by local authorities as independent experts and must be either qualified doctors or lawyers. Their primary function is to investigate any sudden, unexplained, violent or unnatural death in order to allow a death certificate to be issued. Any death due to unnatural causes will require an inquest to be held.

New Zealand

The coronial system operates under the Coroners Act 2006, which:

Established the office of the chief coroner to provide leadership and coordination

Moved to a smaller number of full-time legally-qualified coroners who are Judges of the Coroners Court

Ensured families are notified of significant steps in the coronial process

Introduced wide-ranging cultural matters to be considered in all aspects of dealing with the dead body

Introduced a specific regime for attention and release of body parts and body samples

Enhanced inquiry and inquest processes

Sri Lanka

In Sri Lanka, the Ministry of Justice appoints Inquirers into Sudden Deaths under the Code of Criminal Procedure to carry out an inquest into the death of a sudden, unexpected and suspicious nature. Some large cities such as Colombo and Kandy have a City Coroners' Court attached to the main city hospital, with a Coroner and Additional Coroner.

United Kingdom

There are separate coroner services for England and Wales and for Northern Ireland. There are no longer coroners in Scotland. Coroners existed in Scotland between about 1400 and 1800 when they ceased to be used. Deaths in Scotland requiring judicial examination are now reported to The Crown Office and Procurator Fiscal Service, who investigates deaths on behalf of the Lord Advocate. Different teams investigating deaths include the Scottish Fatalities Investigation Unit, the National Homicide Team, the Health and Safety Investigation Unit, the Road Traffic Fatalities Investigation Unit and The Custody Deaths Unit.

In the rest of the United Kingdom a coroner is a specialist judge. Whilst coroners are appointed and paid by local authorities, they are not employees of those local authorities but rather independent judicial office holders who can be removed from office only by the Lord Chief Justice and the Lord Chancellor. The Ministry of Justice, which is headed by the Lord Chancellor and Secretary of State for Justice, is responsible for coronial law and policy. However, it has no operational responsibility for the running of coroners' courts.

A coroner's jurisdiction is limited to determining who the deceased was and how, when and where they came by their death. When the death is suspected to have been either sudden with unknown cause, violent or unnatural, the coroner decides whether to hold a post-mortem examination and, if necessary, an inquest. The majority of deaths are not investigated by the coroner. If the deceased has been under medical care, or has been seen by a doctor within 14 days of death, then the doctor can issue a death certificate. However, if the deceased died without being seen by a doctor, or if the doctor is unwilling to make a determination, the coroner will investigate the cause and manner of death. The coroner will also investigate when a death is deemed violent or unnatural, where the cause is unknown, where a death is the result of poisoning or industrial injury, or if it occurred in police custody or prison.

The coroner's court is a court of law, and accordingly the coroner may summon witnesses. Those found to be lying are guilty of perjury. Additional powers of the coroner may include the power of subpoena and attachment, the power of arrest, the power to administer oaths, and sequester juries of six during inquests. Any person aware of a dead body lying in the district of a coroner has a duty to report it to the coroner; failure to do so is an offence. This can include bodies brought into England or Wales.

United States

As of 2004, of the 2,342 death investigation offices in the United States, 1,590 were coroners' offices, 82 of which served jurisdictions of more than 250,000 people. Qualifications for coroners are set by individual states and counties in the U.S. and vary widely. In many jurisdictions, little or no training is required, even though a coroner may overrule a forensic pathologist in naming a cause of death. Some coroners are elected with others appointed. Some coroners hold office by virtue of holding another office. For example, in Nebraska, a county's district attorney is also the county's coroner. Similarly, in many counties in Texas, the justice of the peace may be in charge of death investigation. In yet other places, the sheriff may be the lawful coroner.

In different jurisdictions the terms "coroner" and "medical examiner" are defined differently. In some places, stringent rules require that the medical examiner be a forensic pathologist. In others, the medical examiner must be a physician, though not necessarily a pathologist nor further specialized forensic pathologist; physicians with no experience in forensic medicine have become medical examiners. In other jurisdictions, such as Wisconsin, each county sets standards, and in some, the medical examiner does not need any medical or educational qualifications.

Not all U.S. jurisdictions use a coroner system for medicolegal death investigation—some operate with only a medical examiner system, while others operate on a mixed coroner–medical examiner system. In the U.S., the terms "coroner" and "medical examiner" vary widely in meaning by jurisdiction, as do qualifications and duties for these offices. Advocates have promoted the medical examiner model as more accurate given the more stringent qualifications.

Local laws define the deaths a coroner must investigate. The most often legally required investigation is for sudden or unexpected deaths, in addition to deaths where no attending physician was present. Additionally, the law often requires investigations for deaths that are suspicious (as defined by jurisdiction) or violent. In several states across the U.S., the coroner has the authority to arrest the county sheriff or assume their duties under certain circumstances. For example, in Indiana, Colorado, Idaho, Kentucky, Ohio, Alabama, and North Carolina, statutes grant coroners these powers, serving as a check on the sheriff's authority. In Ohio, the coroner can assume the sheriff’s duties if the sheriff is incapacitated or otherwise unable to act.

Notable examples

Wynne Edwin Baxter

Larry Campbell, former provincial coroner for British Columbia

Athelstan Braxton Hicks, late 19th-century coroner in London and Surrey

Thomas Noguchi (born 1927), former Chief Medical Examiner-Coroner for the County of Los Angeles

Charles Norris

Paul Revere, coroner for Boston

Morton Shulman, former provincial coroner for Ontario

William Wynn Westcott

Artistic depictions

Film

In the song "Ding-Dong! The Witch Is Dead", from the classic 1939 film The Wizard of Oz, the Coroner of Munchkinland confirms the death of the Wicked Witch of the East.

Literature

M. R. Hall is a British crime novelist who writes a series of best-selling novels featuring Bristol-based coroner Jenny Cooper.

Novelist Bernard Knight, a former Home Office pathologist and a professor of forensic pathology at the University of Wales College of Medicine, is well known for his Crowner John Mysteries series set in 12th-century Devon, England. (‘Crowner’ is an archaic word for ‘coroner’ and is based on the origins of the word. See the History section above.)

Television

Although coroners are often depicted in police dramas as a source of information for detectives, there are a number of fictional coroners who have taken particular focus on television.

Dr. Camille Saroyan is a federal coroner and the head of the Forensic Division at Jeffersonian Institute in the TV series Bones.

British television drama series The Coroner has as its main character a coroner based in a fictional Devon town.

Crossing Jordan features Jill Hennessy as Jordan Cavanaugh, M.D., a crime-solving forensic pathologist employed in the Massachusetts Office of the Chief Medical Examiner.

The coroners are significant characters and main cast members on CSI: Crime Scene Investigation and its spin-offs CSI: Miami and CSI: NY.

The television series Da Vinci's Inquest has a coroner as its title character.

The American police procedural drama series Hawaii Five-0 features a coroner named Dr. Max Bergman, played by Japanese-American actor Masi Oka.

Kujo Kiriya from the 2016 Japanese TV series Kamen Rider Ex-Aid is a coroner.

In Law & Order: Special Victims Unit, the detectives are regularly assisted by coroner Melinda Warner.

Kurt Fuller plays Woody, a coroner on the American detective comedy-drama Psych.

The television series Quincy, M.E. has the title character (a medical examiner) under the authority of the county coroner.

The television series Wojeck (the Canadian ancestor of Quincy, M.E.) has a coroner as its title character, inspired by the coroner Morton Shulman.