Morticians As CoronersRickey Stokes
Posted by: SamPhuchew
Date: May 14 2018 8:45 PM
Morticians as Coroners
When focusing upon the potential for conflicts of interest of morticians as coroners, first in Georgia and then throughout the United States and Canada, it was interesting to note that about half of the Georgia elected coroners were morticians. Georgia has the highest number of counties among all US states except Texas (Texas has 254 counties, Georgia 159). Further research disclosed that of the just over 3,100 counties in the USA, some 2,076 counties (more often than not rural) use elected coroners and among those, about 500 (24%) are also licensed morticians.
My contention was and is that being a practicing mortician AND a government officiator of death is a conflict of interest. As one coroner put it, "It's like being the only mechanic in town with a wrecker." This conflict of interest takes several forms. First is the issue of competition. If a coroner is at a death scene as the official public investigator, s/he is also "handy" as a private business operator in the event the survivors do not have a mortician in mind. California apparently recognized this when its Attorney General issued an opinion that a mortician could not be a coroner unless s/he was the sole funeral home in the county. This seemed to address the "competition" angle. A Federal lawsuit was filed by a mortician in Worland, Wyoming against the other county funeral home (which employed the county deputy coroner) in a civil rights action claiming that the competitor funeral home/coroner was steering more wealthy clients to his funeral home, among other things.
Other conflict of interest issues also emerge where survivors may enter into a conspiracy of silence with a mortician/coroner. For example, in a suicide by handgun, the coroner may declare the death an accident on the death certificate (the revolver accidentally discharged as the decedent was cleaning it). This may have important survivor's insurance outcomes, as well as emotional, public reputation and religious issues. In gratitude, the survivors may opt for the deluxe funeral package, etc. A few states simply forbid morticians from serving as coroners, such as Washington State. Wisconsin does not preclude morticians from serving as elected coroners, but does prohibit anyone serving as a coroner from entering into any contractual arrangement with the family of a decedent where the coroner is involved as an officiator of death. Needless to say, there are no mortician coroners in Wisconsin. There are other issues as well, such as the coroner having access to the financial records of a decedent in the furtherance of a death investigation.
When the findings of this research on one occasion before the American Academy of Forensic Sciences, I was approached by a coroner who was also a mortician and an amazing exchange took place between us. He cited a case where a man committed suicide with a handgun. The man was an abusive batterer and an alcoholic, regularly beating his wife and children. His wife bravely put up with this behavior for almost 20 years "for the sake of the family and the children." Now that this creep killed himself, the wife gets no life insurance due to a suicide clause and being a stay-at-home Mom with four children, has few job skills outside the home. She will become a ward of the state and will lose her home to foreclosure. However, if he died of an accident, she would get a double indemnity insurance payment of $200,000, which is enough to pay off the mortgage and other bills. This means she can be self-sufficient and not get evicted. The coroner told me that after putting up with all that abuse for twenty years, she deserved some relief. He told me that "that big ol' insurance company can afford it." He called the ruling of an accidental death "contextual justice" and that the sheriff agreed with him, as did other community members that knew of this woman's situation. Now, this exchange does not speak directly to the coroner being a mortician, but does raise some fascinating ethical issues concerning the role of the coroner.
Although a few states (four) using coroner systems acknowledge in their policies (statutes or Attorney General opinions) that it is a conflict of interest for a practicing mortician to also serve as a coroner, the vast majority do not. However, both intuitively and as a result of research, it appears clearly the dual role of practicing mortician and public officiator of the cause and manner of death are conflicting roles to the detriment of the public good.
The American Journal of Forensic Medicine and Pathology frequently contains excellent articles on the history and development of medicolegal investigation systems throughout the world.
Conflicts of Interest
Over the past ten years, research was undertaken after reviewing several graduate student and faculty research papers conducted on the death investigation systems in Georgia and Florida during the period 1987-1994. In several instances, this research pointed to several recurring and disturbing themes concerning conflicts of interest in questioned death investigation systems. The two most alarming studies involved south Georgia counties where, in one county a twenty year study was made of all coroner case reports. The purpose of the study was merely to review the reports to determine if, in the opinion of the researcher and her faculty advisor, investigations were being conducted in a professional manner. In this study, a clear pattern emerged where it became apparent that obvious suicide cases (e.g., contact gunshot wounds to the head) were routinely being classified as accidental deaths for white decedents (but not for blacks). In another study, which involved interviews of former Georgia coroners, complaints were raised by one former coroner that the present coroner, a mortician, used to badger the former coroner to find out how much money a decedent had so that an appropriately-priced funeral could be arranged. In a more recent study of the Georgia coroner system, significant resistance was met in even disclosing the primary occupations of Georgia coroners. The Georgia Coroner's Association would not respond to requests for this information, and individual coroners who were licensed morticians would frequently respond with "Why do you want to know?" or "What business is it of yours?" Over half refused to provide the information. For those counties where the information was refused, the occupation of the county coroner was determined through other sources, such as police or sheriff's offices.
In broadening the scope of potential conflicts of interest in the matter of questioned death investigation, three themes emerged as suitable for inquiry, as follows:
a. Coroners or medical examiners engaged in these public positions as part-time practitioners that steer business into their full time occupation for profit. Examples include medical examiners that are pathologists operating pathology laboratories that contract tests to their own laboratories and coroners that are morticians steering mortuary service business to their firms.
b. Coroners that may agree to present "findings" of a certain manner of death (accident rather than suicide) if the family of the decedent uses the coroner's funeral home for services or, in the case of one study that included inquiries in three states (Georgia, Alabama, and Kentucky) opts for a more costly casket and funeral in appreciation for collecting accidental death insurance benefits (versus no money in a suicide finding).
c. Coroners that may mask the cause and manner of death to serve to the advantage of their full-time practice or organization. Examples include the sheriff-coroner investigating a county jail inmate death, the emergency department nurse-coroner investigating an emergency department death or a paramedic-coroner investigating a death in an ambulance.
In beginning a wider set of inquiries, interviews were conducted in several states between 1993 and 1999 concerning these issues. In many states, the types of questions generated by this research could be summarily answered at the state level, but in others, decentralization of policy is so complete that a detailed county-by-county and even city-by-city inquiry was required.
This study concentrated only upon coroner systems in the United States. Twenty eight states use coroner systems in the U.S.A., while all others and the District of Columbia use the medical examiner system. Eleven states use a form of coroner system exclusively, while 17 have a combination of coroner and medical examiner systems.
Generally, during the research, the potential conflict of interest generated by a death in an emergency department or ambulance where the coroner is an emergency department nurse or paramedic was largely dismissed by those interviewed because of the nature of the job, which is to preserve and save life. Respondents unanimously stated that if a questioned death situation arose at the facility where the coroner was employed as a nurse or paramedic, it would be ethical and logical to bring an a disinterested coroner (e.g. from another jurisdiction) to investigate. In fact, this procedure is policy in several states.
The conflict concerning morticians serving as coroners, however, generated considerable controversy. Most state representatives interviewed acknowledged that the role of coroner and mortician is clearly an ethical conflict. In addition to the above cited reasons, an additional conflict of interest issue also emerged from the national interviews: Mortician-coroners will tend to avoid having an autopsy performed because of pressure from the survivor-customer of the mortician and/or because an autopsy makes embalming difficult.
The biggest conflicts of interest exist in the smaller counties where there are more than one, but just a few, funeral directors. It is beneficial for a funeral director to be coroner,” Randall said, adding that even honest coroners who are funeral directors could end up getting extra business.
No matter how the solution is solved an additional issue must be addressed: the election of funeral directors as coroners. Aside from all other issues relating to the coroner’s office, this practice is the most controversial and unjust. Funeral directors are supposedly experts on death, so why wouldn’t they make good coroners? First, this is because expertise in memorial services by no means implies expertise in forensic science. The two fields are unrelated.
Secondly, and more importantly, consider the massive conflict of interest between the two positions. The coroner needs to complete a thorough investigation of the cause of death, but the funeral director wants to keep his business by moving the transaction as quickly as possible. Some funeral director/coroners even promote their own businesses while dealing with families who have just lost a loved one. Funeral director Ernie Heffner from Milton, Pennsylvania experienced this firsthand when the coroner’s election became a popularity contest between funeral directors in which the winner gains a massive, unfair advantage. Josh Slocum, executive director of the Funeral Consumers Alliance, calls this practice an “an egregious abuse of government authority” and directly states, “there should be a law that prevents funeral directors from becoming coroners.”
But this practice, thankfully, is something we can change simply by paying attention. Wherever a coroner’s office cannot be replaced or reformed, we can at least know who not to vote for. We must remember that the death industry, like any industry, looks for ways to advance its own ends. It is our job to create within our communities the change we hope to see in end of life investigations.
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Prior to the lawsuit being filed, Creel had requested a policy change from the county multiple times, according to the complaint. At the county's request, both Sipe and an attorney with the Montana Association of Counties reviewed the arrangement, the latter finding that Brown's business had a "built-in advantage" as a result of his position.
The whole thing is just so corrupt. The last thing a grieving family should have to be concerned about, is being solicitation by a Coroner/Deputy Coroner.
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