While many types of medical doctors are capable of performing autopsies, most states or local government laws mandate that an appointed forensic pathologist do the work. These appointees are called medical examiners and have an official position in the county medical examiner system
Not all counties use the medical examiner system. Some counties use coroners and a coroner's system. There are two major differences between medical examiners and coroners and their corresponding systems.
Dr. Kiesel explains:
A medical examiner by definition is a physician ... In most cases, they are trained to be forensic pathologists... and are appointed to their positions. To be a coroner, you just have to be able to be elected to the job. You've got places where the local feed store operator is a coroner. I've got a friend out in Washington State who's a farmer, who's the coroner of his county.
Many coroners are qualified pathologists with years of experience. Some are physicians in unrelated fields. But depending on the county laws, a coroner may require no medical qualifications at all in order to perform his or her duty. This fact raises two questions:
First, why would a county opt for a coroner system over a medical examiners system if the differences in qualifications can be so great?
The answer is resources. In most rural areas, there may not be a whole lot of qualified forensic pathologists around nor the facilities needed for them to do their jobs properly. Additionally, rural areas with very little or no violent crime or unexplainable deaths don't need a full-time forensic pathologist.
The second question is: What is a feed store coroner going to do when faced with a dead body?
Dr Kiesel answers, "He's gonna go out and say, 'Well, he's dead.' That's the coroner's official duty."
The coroner is also responsible for:
- Identifying the body
- Notifying the next of kin
- Collecting and returning any personal belongings on the body to the family of the deceased
- Signing the death certificate
Some states, like Louisiana, require coroners to be forensic pathologists, but most county coroner systems do not. In the event that a non-medical coroner needs an autopsy performed, he or she can have it sent to a medical examiner. In some states, the government will provide the coroner with a medical examiner for the autopsy.
In the next sections, we will detail the process of examining a dead body inside and out.