There’s no one way American states conduct death investigations, according to information from the Centers for Disease Control. Each state is different, but medical examiners are typically appointed, while coroners are either appointed or elected.
Nine states use systems with only coroners, 21 states use systems with only medical examiners, 19 states use some combination of medical examiners and coroners, and Texas’s system combines justices of the peace and medical examiners.
Under South Carolina state law, coroners are elected to a county position and serve four-year terms.
Why the Office is Elected
In South Carolina, the business of medicolegal or death investigations straddles the line between medicine and law enforcement, but is intended to remain autonomous from both, according to Charleston County coroner Bobbi Jo O’Neal, president of the South Carolina Coroners’ Association.Keeping the coroner an elected position is supposed to keep the office independent and unbeholden to other authorities.
“It’s to represent individuals, but it’s also to make sure that no one can tell the coroner to stop investigating,” O’Neal said. “I don’t work for the mayor, the sheriff, the governor, whomever. I work for the decedent.”
According to O’Neal, there have been state-level discussions about appointing coroners, but that raises the question of who should appoint the position.
Who Can Run
Although coroners work intimately with death, in South Carolina and most other states with coroner systems, coroners don’t have to be physicians or forensic pathologists.The only education theSouth Carolina Code of Laws requires a coroner to have is a high school degree or equivalent, though coroners must complete a basic training session determined by the South Carolina Criminal Justice Academy within a year of election.
The state also requires a candidate for coroner to be a U.S. citizen at least 21 years old who is registered to vote and has lived in the county for at least a year before the election. State law also stipulates that a person convicted of a felony or “an offense involving moral turpitude” can’t run for coroner.
Medicine and Law Enforcement
Beyond these qualifications, there are two paths a person can take to qualify to serve as coroner: law enforcement and medicine.“In most cases, in South Carolina, you’re not going to find a doctor or a nurse that wants to be a coroner, because the pay is just nowhere near equivalent to a medical doctor or a registered nurse,” said Sumter County coroner Robert Baker, who serves as legislative liaison for the SCCA.
Without a medical doctor in a coroner’s office, especially in offices like Baker’s where none of the staff comes from a medical background, coroners rely on resources like the decedent’s doctor for medical information and expertise, he said.
When an autopsy is deemed necessary, the procedure is outsourced to board-certified forensic pathologists, though state law says the autopsy can’t be performed at the health care facility where the person died, by a physician employed by the facility or by the decedent’s treating physician.
“80 percent are natural deaths, so having an understanding of medication and what’s normal and not normal and all that is important,” said O’Neal, who is also a registered nurse. “But I have a number of investigators in my office who come with a law enforcement background, and they’re great investigators.”
While O’Neal says mixed backgrounds are ideal, there’s no mandate that requires South Carolina coroner’s offices to have any combination of medically or legally trained investigators.
The South Carolina Code of Laws says a person is qualified to run for coroner if they have:
- Three years of experience investigating deaths with a law enforcement agency
- A two-year associate degree and two years of experience investigating deaths with a law enforcement agency
- A bachelor’s degree and one year of experience investigating deaths with a law enforcement agency
- Certification by the South Carolina Law Enforcement Training Council with two years of experience as a law enforcement officer
- A bachelor’s degree in nursing
- Or are a medical doctor
“The language says a person can be enrolled in one of the two recognized programs, if they have no if they have no experience, to run for coroner,” Baker said. “We’re working on getting the enrolled language changed to where you either have completed the program or not, and if you haven’t, you can’t run.”
What Coroners Do
At the most basic level, coroners and medical examiners are responsible for medicolegal investigations, scientific inquiries that determine the circumstances of a person’s death.But the job entails quite a bit more.
“We really are a representative of the decedent, speaking for them and then, as an extension their family, making sure that all the circumstances surrounding their death is documented and that we have it correct,” O’Neal said.
In South Carolina, coroners investigate all manner of deaths, including deaths that are a result of violence or an apparent suicide, deaths of people who were in apparent good health, unusual or suspicious deaths and deaths of inmates in penal or correctional institutions.
They are also responsible for conducting investigations of deaths and stillbirths unattended by a physician, deaths within 24 hours of invasive surgery procedures at health care facilities and deaths within 24 hours of entering any health care facility besides nursing homes.
The coroner’s office is also responsible for notifying the decedent’s family of their death and investigating situations where human remains, like bones or bone fragments, are found.
“It impacts the criminal justice system, we impact the public health system and we impact the emergency management system,” O’Neal said.
Politics in Death Investigations
Candidates for coroner in South Carolina also run with party affiliations, a practice with which some coroners disagree.“I personally feel like the coroner’s position should be non-partisan. There is nothing political about investigating the cause and manner of a person’s death,” said Baker.
In this year’s general election, 26 candidates are running as republicans and 15 are running as democrats for coroner.
“Unfortunately, that’s something that has been put in writing, that both state parties want that constitutionally county-wide elected official to be affiliated with a party, either democrat, republican or independent,” Baker said.
Of the 39 county coroner races this election cycle, only a third of counties had primary challenges, according to the South Carolina Election Commission. 12 candidates were defeated in primaries, one withdrew and one was disqualified before the actual primary election.
There are even fewer challengers after the primaries end.
The vast majority of coroner candidates on the ballot in the general election are uncontested, according to the South Carolina State Election Commission. Only two South Carolina counties with coroner elections this year have more than a single candidate on the ballot, Charleston and Jasper.
“I think it should be elected. I think it should be non-partisan, but the citizenry needs to pay attention, because we really impact a lot of things,” O’Neal said.
Rulings on deaths can have far-reaching and important consequences. Overdose information influences drug and intervention policies. Identifying and tracking deaths caused by illnesses informs understanding of public health dangers.
In determining the cause and manner of a person’s death, a coroner can impact a decedent’s family’s life insurance pay out. In a state like South Carolina, which practices capital punishment, a coroner’s findings also affect whether a person is charged with a crime.
In 37 of 39 counties with 2024 elections, the coroner making those calls has already been decided.
©2024 The State. Distributed by Tribune Content Agency, LLC.
