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February 19, 1997

Medical Examiners, Forensic Pathologists, and Coroners

Author Affiliations

Bexar County Forensic Science Center San Antonio, Tex

JAMA. 1997;277(7):531. doi:10.1001/jama.1997.03540310029023

To the Editor.  —After reading the article on coroner training needs by Dr Hanzlick,1I feel like I am viewing the rearranging of deck chairs on the Titanic. The basic problem, which politicians, the courts, and, to a lesser degree, the medical profession refuse to face, is that the coroner system is antiquated. It is time to replace coroner systems with medical examiner systems that employ forensic pathologists to decide which corpses need to be autopsied, to perform the autopsies, and to certify the cause and manner of death.In certifying deaths, coroners are making medical diagnoses without medical knowledge. They are rarely physicians, let alone forensic pathologists.2 Coroners may receive advice on what the ruling on cause of death should be from pathologists they employ to perform autopsies, but are under no legal obligation to follow this advice. Coroners decide when an autopsy is necessary, a crucial

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