Variation exists in how death examinations take place in the United States. In some counties and states decisions about autopsies and the issuance of death certificates are made by a local coroner who often needs nothing more than a high school diploma to run for election to the job of coroner. In other counties and states, an appointed medical professional performs the death examination. We provide preliminary tests of the difference in performance between death examination offices run by appointed medical professionals compared with elected coroners. We find that death examiner offices in elected coroner states are less likely to be accredited by the major national organizations and correlate with greater amounts of autopsy related litigation. We also find some evidence that the historical shift from elected coroners to appointed medical professionals was more likely in states with less of a preference for direct democracy as proxied by the system of state supreme court judge selection. 




Stephen J. Choi & G. Mitu Gulati, Adjudicating Death: Professionals or Politicians?, 70 Vanderbilt Law Review, 1709–1727 (2017).