Canada needs national body to set standards for coroners, medical examiners

Canada should create a national body to set and enforce standards for medically reporting death because no such body exists, argues an editorial in CMAJ (Canadian Medical Association Journal).

"Despite the importance of medicolegal investigation of deaths, there is no accreditation system for coroner or medical examiner offices, no national standards for the investigation or classification of death, no nationally recognized training program or credentialing system for coroners and medical examiners, and no agreement on common outcome measures against which to evaluate performance," write Dr. Diane Kelsall, Deputy Editor, CMAJ, with Dr. Matthew Bowes, Chief Medical Examiner, Nova Scotia.

Accurate determination of cause of death has important legal and public health implications.

Unexplained or unnatural deaths are investigated provincially or territorially, with no national oversight. Of the 230 000 residents who die in Canada each year, between 7% and 45% of deaths are investigated, depending on province or territory, and autopsy rates vary considerably.

The authors suggest that Canada should create a body similar to that in the United Kingdom to develop and oversee standards as well as national training and accreditation programs.