Who has authority to determine whether death was natural, accidental, suicidal, or homicidal?

Question

My understanding is that generally (and in broad strokes) it is the responsibility and authority of a jurisdiction's Coroner (a.k.a. Medical Examiner) to determine the cause and manner of any death not certified by an attending physician.

Suppose someone is found dead after a fall. Suppose the Coroner, on reviewing the body and scene, finds nothing but deadly injuries consistent with the fall and the circumstances in which the body was found. Now, one of four scenarios is possible:

1. The person died of natural causes and then fell (natural death)
2. The person fell accidentally (accidental death)
3. The person fell intentionally of their own volition (suicide)
4. The person was caused by another to fall (homicide)

Does the Coroner have the final say on cause of death?

Or do any other offices have the right to investigate a death to look for evidence of homicide in opposition to a verdict of the Coroner? For example,

• Can police pursue an investigation independent and contrary to that of the Coroner?
• Does a District Attorney (when not the Coroner) have the means and/or authority to conduct an independent and contrary investigation?

Answer 1

Short Answers

1. Does the Coroner have the final say on cause of death? No. The trial judge (or jury) has the final say.

2. Can police pursue an investigation independent and contrary to that of the Coroner? Theoretically, yes. But I would expect that would happen only in unusual circumstances. Like, maybe an internal investigation. Standard procedure is for the prosecutor, police and medical examiner to work together to investigate crimes and prosecute criminals.

3. Does a District Attorney (when not the Coroner) have the means and/or authority to conduct an independent and contrary investigation? Yes. But it's unusual. See answer to number 2.

4. Or do any other offices have the right to investigate a death to look for evidence of homicide in opposition to a verdict of the Coroner? Same answer as #2 and #3.

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Explanation

They work together on the same team

The medical examiner is a state employee and usually works on the side of law enforcement. If a medical examiner were to report a cause of death that did not support evidence of a crime, that information would have to be made available to any potential defendant. In the hands of any competent attorney that should be sufficient basis to create reasonable doubt and achieve an acquittal. I doubt many prosecutors would ever consider hiring an outside examiner in this case except under highly unusual circumstances like an internal investigation as mentioned above.

The defendant must create reasonable doubt

In the alternative scenario, when evidence of a crime is supported by the M.E. report, it would be up to the defendant to produce reasonable doubt by cross-examination or producing expert testimony that contradicts the M.E.'s conclusion. This might or might not include hiring an independent third party forensic pathologist as an expert witness. Dr. Cyril Wecht is a famous one.

All opinions are subject to error, disagreement and cross-examination

All that said, the "cause of death" reported by the Coroner is just a medical opinion and is subject to error and disagreement like any other opinion. It's just that it's unlikely that disagreement would come from the side of law enforcement in most cases.

For further reading, here is a link to the Coroner's Handbook. At the bottom of page 11, it acknowledges:

Causes of death on the death certificate represent a medical opinion that might vary among individual medical-legal officers.

Answer 2

In Washington State, "cause of death" is part of a Vital Record under RCW 70.58, specifically a death certificate. RCW 70.58.170 says who may file a death certificate: "The funeral director or person having the right to control the disposition of the human remains under RCW 68.50.160 shall file the certificate of death or fetal death". That person

shall present the certificate of death to the physician, physician's assistant, or advanced registered nurse practitioner last in attendance upon the deceased, or, if the deceased died without medical attendance, to the health officer, medical examiner, coroner, or prosecuting attorney having jurisdiction, who shall certify the cause of death according to his or her best knowledge and belief and shall sign or electronically approve the certificate of death or fetal death within two business days after being presented with the certificate unless good cause for not signing or electronically approving the certificate within the two business days can be established.

So there are many people who might be presented with the certificate, but no judges or juries. "Cause of death" is part of the information entered on the death certificate.

When a person dies "without medical attendance", RCW 70.58.180 is applicable. In that case, the person disposing of the body "shall notify the coroner, medical examiner, or prosecuting attorney if there is no coroner or medical examiner in the county". If the death is not suspicious, the person so notified completes and signs the form, noting lack of attending medical practicioner, and notes cause of death without an autopsy, relying on "statements of relatives, persons in attendance during the last sickness, persons present at the time of death or other persons having adequate knowledge of the facts".

However,

If the circumstances suggest that the death or fetal death was caused by unlawful or unnatural causes or if there is no local health officer with jurisdiction, the coroner or medical examiner, or the prosecuting attorney shall complete and sign or electronically approve the certification, noting upon the certificate that no physician, physician's assistant, or advanced registered nurse practitioner was in attendance at the time of death.

In either case,

The cause of death, the manner and mode in which death occurred, as noted by the coroner or medical examiner, or if none, the prosecuting attorney or the health officer and incorporated in the death certificate filed with the department shall be the legally accepted manner and mode by which the deceased came to his or her death and shall be the legally accepted cause of death.

So: the law allows many people (in a hierarchy) to provide the legal cause of death, which shall be recorded on the certificate of death.

The statute pertaining to county coroners potentially broadens the scope of cause of death a bit. A county coroner has the power to hold an inquest into a suspicious death. Then, RCW 36.24.070 states that

After hearing the testimony, the jury shall render its verdict and certify the same in writing signed by the jurors, and setting forth who the person killed is, if known, and when, where and by what means he or she came to his or her death; or if he or she was killed, or his or her death was occasioned by the act of another by criminal means, who is guilty thereof, if known.

There is nothing in the statute that specifically mandates that the coroner "accept" the verdict of the jury. Some details are left to county-specific procedure, this being the law for King County. This finding is separate from the medical / vital records concept of "cause of death".

In other words, whoever fills out the death certificate provides the legal cause of death.

Answer 3

I would have to disagree with Mowzer.

Does the Coroner/Medical Examiner have the final say on cause of death? YES. The trial judge (or jury) have NO say in the cause or manner of death. The state constitution provides jurisdiction to either a medical examiner or coroner (depends what system the state uses) to submit to state vital statistics agency the COD/MOD and that is the official record. The medicolegal authority has the option to change it as new information becomes available (the COD/MOD is never final; it's always open to re-evaluation). However, the chief medical examiner within a jurisdiction has the final authority over any deputy ME and may overrule their MOD/COD.

Can police pursue an investigation independent and contrary to that of the Coroner? Absolutely! The police are not bound by what the coroner says (they're independent of each other). In fact, the police often later uncover information that causes a change in the MOD; these are appended death certificates and the most recent one is the official record.

Does a District Attorney (when not the Coroner) have the means and/or authority to conduct an independent and contrary investigation? Also, Absolutely!! An example: I'm cleaning my gun with a friend when it accidentally discharges and kills my friend. Coroner would likely rule that a homicide (I did kill someone, regardless of intent). However, it's up to the DA whether they want to press homicide charges; if the DA declines to press charges, then from his viewpoint, it was an accident. Again, the police/DA are completely independent from the coroner/ME.

That being said, an independent investigation may come to a different conclusion (good grief, within the same ME office there's not always a consensus) but that outsider conclusion is an consult only and does not overrule the local medicolegal authority.

Or do any other offices have the right to investigate a death to look for evidence of homicide in opposition to a verdict of the Coroner? Same answer as #2 and #3. [on that, we can agree ;-) ]

Bottom line: this is the intersection of medicine and law. One cannot overrule or dictate the actions of the other, but they may support or detract each others conclusions. Always tension.