WHEN IS A
CORONER NEEDED? WHAT ABOUT AN AUTOPSY?
Not all deaths are reportable to the Coroner. Those deaths that are reportable fall into 25 categories. Those categories are:
1. No physician
3. Wherein the
deceased has not been attended by a physician in the 20 days prior to
Once a death is reported to the Coroner, it is the Coroner’s responsibility to investigate the death and the determinations as outlined above. From this point, the Coroner may close the case as a “Physician Certified death” meaning that a physician has reviewed the circumstances and deemed that the death was of obvious natural cause. Only a fraction of the deaths reported to the Coroner result in a full autopsy.
While many may object to autopsy for religious or other reasons, some of which are discussed below, there is an argument for the continuation of autopsies and even the expansion of autopsies performed. Dr. Richard Horowitz, Professor of Pathology at UC and UCLA School of Medicine, states that “In up to 40% of autopsies, there is some finding that was not clinically suspected, and in many of those cases, the patients' lives might have been prolonged had the diagnosis been made. Yet, there is no outcry; no one seems to care that so few autopsies are now done.” Dr. Horowitz goes on to state that “Clinicians don't care because they fear that autopsies may expose their mistakes. Many pathologists don't care either -- autopsies take time and are not reimbursed. Hospitals and health systems don't care because autopsies don't improve their ‘bottom lines.’"
In those deaths where the Coroner needs further investigation, the coroner or medical examiner has the legal authority to order an autopsy without the consent of the deceased person's family (next of kin). If an autopsy is not required by law, it cannot be performed until the deceased person's family provides permission.
Family members may have concerns and strong emotions about an autopsy being done on a loved one. It is important that the family understand that the autopsy is a medical procedure performed respectfully and carefully, to objectively evaluate disease or injury that may be present and to determine the cause and manner of the loved one's death.
Issues for the family to consider when a loved one is to be autopsied are:
1. Organ or
tissue removal for donation purposes generally requires separate
permission from an autopsy.
The Coroner’s Unit and County Public Administrator office work together to ensure that indigents are buried, or by Board of Supervisors resolution in Monterey County, cremated. If estate funds are available to pay for the burial or cremation and the Public Administrator is administering the estate, the Public Administrator will make arrangements to pay the costs of burial or cremation from the estate. If no estate funds are available, the Coroner Unit is responsible to see that this duty is carried out at county expense.
Administrator acts as administrator in estates where there are assets to
distribute, no known estate plan (Will or Trust) and no immediately
known heirs or next of kin can be found.
Some people may have an objection to autopsy due to religious belief or, as is becoming more and more popular today, some may want to be cryogenically frozen for resurrection at a later time. If the Coroner or Medical Examiner requires that an autopsy be performed, this may undermine arrangements made with regard to cryogenic freezing. Younger decedents are particularly at risk of autopsy since death at a young age is most likely to be the result of an accident, homicide, or sudden unexplained illness.
Some state legislators (California being one of those States) have moved toward restricting the power of the state to demand an autopsy. One statute which has been passed in at least five states (California, Maryland, New Jersey, New York, and Ohio) is the "Religious Objection to Autopsy." Simply, it gives people the right to attempt to prevent an autopsy of their remains by signing a certificate declaring that autopsy is contrary to their "religious belief." (A person completing such a form is not required to state what his/her religion is.)
In states that have passed a religious objection law, this form may be the most effective way to prevent autopsies and to limit the scope of those which are performed. If you or your family objects strongly to autopsy due to religious or other reasons, you may consider executing the California Certificate of Religious Belief attached. Remember, with this form as with all legal documents, work with your attorney to make sure it fits into your overall estate planning.
Keep in mind that the Coroner or Medical Examiner will not request an autopsy unless there is a clear and convincing reason for them to do so. If you execute a Certificate as mentioned above, you may be losing an opportunity for your family to benefit from the knowledge of a clearly diagnosed medical issue that may be hereditary or you may be “burying” evidence of some wrongdoing that would have otherwise been discovered and possibly prosecuted.
considered, if the
California Certificate of Religious Belief is of interest, there is
a copy attached. Weigh the consequences and speak with your legal
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