B.C.'s coroner system questioned by forensic pathologist

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      A renowned forensic pathologist says B.C. should change its system for investigating sudden deaths.

      John Butt is recommending a shift from the current coroner setup to a medical examiner system, which is used in a number of other provinces, namely Alberta, Manitoba, Nova Scotia, and Newfoundland and Labrador.

      “In the investigation of sudden death, there are five questions that have to be answered,” Butt explained to the Georgia Straight in a phone interview. “The question that carries the greatest responsibility and is commonest and costs the most money is the question ”˜Why?’, which is the medical cause of death.”

      Butt is a former chief medical examiner for Alberta and Nova Scotia. He now works in Vancouver as a private consultant in forensic medicine, and specializes in providing expert testimony.

      B.C.’s Coroners Act doesn’t require the chief coroner to have a medical background. For almost 30 years, between 1981 and 2010, the post was held by ex–police officers. Robert Galbraith was followed by Vincent Cain; Larry Campbell, who later became Vancouver mayor and is now a Liberal senator; and Terry Smith.

      On April 1, Diane Rothon took over the B.C. Coroners Service, becoming the second physician to head the death investigation agency since the province’s first chief coroner, William McArthur, who held the position from 1979 to 1981.

      Although Butt is pleased that the new chief coroner is a doctor, he suggested that the province consider introducing a medical examiner system.

      “The medical examiner system is led, governed by an expert in forensic pathology,” he said. “That means that they have to be a forensic pathologist, not just a doctor. Just like the operating room is the tool of the surgeon, the tool of the forensic pathologist is the autopsy.”

      Butt pointed out that the B.C. Coroners Service doesn’t have forensic medical expertise. As such, it contracts out autopsies to hospitals.

      The Ministry of Public Safety and Solicitor General didn’t make Rothon or any other official available for comment. However, in a statement e-mailed to the Straight, a ministry spokesperson asserted that there is no compelling reason to switch to a medical examiner system.

      Like Canada, the U.S. employs a mix of coroner and medical examiner models in different jurisdictions. However, a report released last year by the National Academy of Sciences, a Washington, D.C.–based private advisory body, recommended Congress earmark funds to set up “medical examiner systems, with the goal of replacing and eventually eliminating existing coroner systems”.

      The report cited the need for unbiased death investigations in sensitive cases like police shootings and those occurring in jails, as one of the reasons for having a medical examiner. “The medical examiner is first and foremost a physician, whose education, training, and experience is in the application of the body of medicine to situations that have a legal dimension that must be answered by a practitioner of medicine,” the document states.

      For many years in B.C., deaths in police custody were automatically subject to coroners’ inquests. However, in March of this year, the provincial government passed legislation giving the chief coroner the discretion to waive inquests in these cases, a move that civil-liberties advocates like lawyer Cameron Ward argue will weaken police accountability.

      How this new legislation will be implemented is one of the issues the B.C. Civil Liberties Association intends to raise with Rothon in a meeting scheduled for June 1, BCCLA executive director David Eby told the Straight.

      Comments

      4 Comments

      SE Aitken MD

      May 30, 2010 at 5:10pm

      BC might be best served by using a coroner system such as in Ontario. The clinical physician's medical knowledge coupled with a forensic pathologist's specific knowledge provide a good balance in determination of cause of death and ultimately the manner of death.

      C. Harris. BSN

      Jun 5, 2010 at 9:37pm

      He makes it sound as if there is no forensic medical expertise associated with the coroners service. All autopsies are contracted out yes, but they are all done by forensic pathologists.

      The easy was to address any of the so-called concerns around medical examiner versus coroner system would be to utilize "forensic trained nurses" to work as coroners rather than lay persons.

      Also, the new Chief Coroner is now a physician and doesn't do the day to day field work of investigating death anyway it is a management position which relies on the expertise of those around him/her on the frontlines.

      The problem that is usually associated with the Coroner systems in the U.S. is that they are all elected positions for the most part and are politicians and have no related experience at all in a lot of cases and require no continuing education etc. Much different than the coroner system here in BC.

      Rockwell

      Jun 7, 2011 at 6:12am

      This article illustrates that we cannot be complacent with respect to experts. Those who are interested in this topic will want to attend the Evidence Based Medicine and Social Investigation Conference 2011, August 4, 5 and 6. For more details:

      http://evidencebasedmedicineandsocialinvestigation.wordpress.com/

      Hamish

      Dec 18, 2012 at 8:57am

      there is a conflict with police investigating police. there is also a conflict with physicians investigating physicians therefore a coroners should be a diverse group