31 January 2008

Don't Elect Coroners

Allegheny County, Pennsylvania (Pittsburg) no longer elects coroners. They stopped doing so in 2006, replacing the elected post with an appointed medical examiner office after a scandal involving elected coroner Cyril H. Wecht.

Do we have to wait for a similar scandal in Colorado before we see reform?

Colorado elects coroners on a partisan basis outside Denver and Broomfield, which are cities and counties that are granted great flexibility in how they structure their affairs than other counties. The coroner's main job is to determine the cause of death in cases where it is unclear or suspicious. The coroner is also the equivalent of a "Vice President" for the county Sheriff, although state law could easily vest that responsibility in someone else. A state constitutional amendment in 2002 authorized the legislature to establish training and certification requirements for the office, but this was only a partial solution.

Colorado has had some close calls. Not long ago a Montrose County Coroner, an EMT who won by a nose in the Republican primary, wrongfully accused the local hospital of murdering patients in connection with organ transplants based upon his personal internet research. The legislature had to respond to preserve the state's life saving organ donations system. Ouray's county coroner has such a small and hence underfunded office, that he has to drag bodies around in the back of his personal truck -- something a jury might not take kindly to in a murder trial.

While the job of coroner does involve a great deal of discretionary decision making in hard cases, there is no Democratic or Republican way to conduct an autopsy. The job is quintessentially technocratic, and to do it right, the job should be held by a medical doctor, ideally, a forensic pathologist. This is the kind of job where the merit system of hiring government employees under the civil service system can work very well.

The political process is prone to electing someone low on competence with strong partisan views about when life begins and ends, or someone who simply craves political power that answers to no one (the county commissioners are co-executives with the coroner, not the coroner's boss). In contrast, the political process is not particularly well suited to selecting technocratically qualified people who are good at resolving difficult homicide v. suicide v. accident questions from physical evidence in a credible way. Even if ideology isn't an issue, and the actually work can be delegated to underlings upon whom an elected coroner can rely, the need to raise funds and have connections in political parties in order to run for a partisan political office will almost inevitably create suggestions of improper influence in a determination of the cause of a high profile death sooner or later.

Also, Colorado simply has too many coroner's offices. Colorado has 64 counties in a state of 4.6 million people. Some, like Ouray, have only a few hundred people. Most have fewer than 100,000 people. Not every county needs, or can afford, the staff and equipment for it's own first rate medical examiner's office. Even large metropolitan counties need only a handful of professional staffers in the coroner's office, despite having the population of dozens of Colorado's more rural counties. The overwhelming majority of people die in circumstances in which the cause of their death is obvious and non-controversial, requiring no investigation or documentation of consequence.

Consolidation of coroner's offices would also allow credible medical expert based uniform standards for investigations of deaths to be established statewide, sparing the state scandals like the one it went though in the past few months over the state's failure to establish uniform standards concerning the preservation of physical evidence -- something that has harmed innocent people wrongfully convicted and cast doubt on valid convictions. Delegating responsibility for a government function to 64 different partisan elected officials who report to no one, with only minimal educational requirements, is not a good strategy for achieving uniform minimum science based standards and quality control.

If we must continue to elect coroners, we should do so on a non-partisan basis, either in each of the state's 22 judicial districts, the same regional level at which District Atttorneys who prosecutes almost all violent crime in the state are elected (with funding shared by counties in the district), or at the state level, like the attorney general, as a non-partisan state medical examiner.

Better yet, we could have an appointed state medical examiner's office, harnessing the resources of the entire state to get the best forensic pathologists and laboratory equipment available, with local offices set up in a manner driven by logistics rather than politics. The state medical examiner could be appointed by the Governor through the civil service system, using a method similar to that used for the state's judiciary (the Board that regulates the medical profession might vet nominees in the way that Blue Ribbon commissions do for judicial appointments). Despite this job's importance, it does not need to be a politically appointed policy making post in the Governor's cabinet.

Another side effect of this change would be to shorten Colorado's excessively long ballot, removing a post which voters are in a poor position to cast an informed vote upon anyway.

A bad appointed state medical examiner could be removed for cause like any other state employee, without the delay and cost associated with using the political process, or via impeachment, a little used safety valve that can remove any state employee from office in extreme circumstances that usually gives the accused an opportunity to rebut the charges in a forum other than the newspapers at legislative hearings on the matter.

Yes, this proposal would require a state constitutional amendment and voter approval. But, wouldn't it be worth it to act now in order to prevent some major problem down the line?


Andrew Oh-Willeke said...

The State, a newspaper in Lexington, Kentucky, agrees with my sentiment on the issue, i.e. that administrative technocratic county officials should not be elected officials.

Andrew Oh-Willeke said...

Oops, link for the comment above.