The Difference Between Coroners And Medical Examiners

When a person dies in the United States, it's required for a cause of death (if one can be determined) to be listed on the death certificate. For those who might die under suspicious circumstances, an autopsy is typically performed, in part so it can notify law enforcement if foul play was involved. But whether from natural causes or homicide, a person's death is an involved process on a bureaucratic level that involves several professionals and a lot of paperwork. 

The death must be reported and recorded and the next of kin notified, as well as a decision being made as to whether or not a post-mortem exam is necessary to determine the cause of death. Death keeps some folks busy. The bulk of these duties rests on the shoulders of two persons, the coroner, and the medical examiner.

Some might believe these two titles are one and the same. While it's true that the two of them do share a good amount of responsibilities that overlap, the positions have different sets of qualifications. And in some states, they are brought into the job in entirely different manners (per Mopec).

The two titles can be a bit confusing, especially when some folks will erroneously use them interchangeably. But a close look at the history of both positions, as well as the qualifications for them, reveals that there is indeed a big difference between them.

Coroners are typically elected and may not have experience in the medical field

The role of a coroner in the United States has been around since the 17th century when it was still under rule by the British Crown (per Mopec). Washoe County gives a bit of history on the subject of coroners, reporting that the title is derivative of the word "crowner," whose job it was at one time to collect taxes for the royal government whenever someone died. Since then, the duties and responsibilities of the coroner have greatly evolved to include a lot of paperwork and investigating.

A coroner is almost always an elected position at the county level. Their lengthy to-do list includes filling out and filing the death certificates and making official inquests about the deceased's cause of death. Typically, a coroner is not a medical doctor, and might not have any medical background at all. Therefore, they are not able to perform forensic examinations or autopsies unless they have the license and credentials to do so. But a coroner will have the power to make an inquest on a person's death and order post-mortem medical examinations from a forensic pathologist.

How Stuff Works outlines the additional duties of the coroner. Aside from taking care of the death certificate, the coroner is usually the person who notifies the next of kin about the death. They will also handle the personal belongings that were on or around the deceased when they died.

A medical examiner is always a physician

While the coroner is an elected position, a prospective medical examiner doesn't have to jump through the hoops of the electoral process to get their job. These folks are appointed or hired on by a local government (via Mopec) and do not have their jobs at the mercy of a fickle electorate. But the differences between these professionals and their coroner counterparts do not stop there.

A medical examiner is a trained physician. Because of their extensive education and specialization, they can conduct thorough medical examinations on a corpse, should it be requested by the coroner. A medical examiner is a person who takes care of all medical issues relating to a death, which may also include investigating body tissue samples, toxicology reports, and anything else medically related that could help determine the cause of death.

About half the municipalities in the U.S. have a medical examiner system in place, with many of those counties giving the title of coroner to the appointed medical examiner. This combines the role of the traditional coroner with the more modern medical examiner system and takes the politics out of it entirely (via Washoe County). The source indicates that this system may well be the way things are done in the future.

But not all areas have begun to adapt to this system. Counties with fewer resources cannot afford to have a full-time medical examiner, opting to use the services of trained pathologists only when needed (via Mopec).