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From "THE GAZETTE,' February 8th, 1894. Home time ago tbe Medico-Cbirursical society of Mootrsal appointed a commit- tee conBisting of Drs. (i. P. Gird wood, J. G. Ademi, E. P. Lacbapelle and J as. Bell to study tbe law and manner of condiict- iut; inquests in tbis province. The result bas b3en reported to tbe committee, and tbe report transmitted to tbe Attorney- General and tbe medical members of tbe Legislature. AmonK otber tbings it says : — The present provincial laws respecting enquiries into tbe mode and cause of deatb are based essentially upon ttie old Knglisb common law. Tbe em^uiries are placed in tbe control of coroners appoint- ed by tbe provincial Government, a cor- oner for eacb judicial district. Ibe cor- oner need not be a member of eitber tbe legal or tbe medical profession, altbougb in tbeereat majority of cases be belongs to one or tbe otber. Upon receiving notice of a case of deatb following upon any act of violence, or of deatb attended by suspicious circum* stances, it is bis duty to make a prelim- inary enquiry. If, with or witbout medical aid, be comes to tbe conclusion tbat tbe cause of deatb is to be made out witbout tbe as- sumption of tbere baving been eitber criminal act or criminal neglect, be can order tbe interment of ttie body. If, on I cbe otber band, be is led to suspect tbat [ deatli has been due to violent or unfair \ means, or culpable or negligent conduct Of others, under circumstances calling for I investigation by a coroner's inquest, then, ; baving made a sworn deposition to tbis effect before a magistrate, be is empow- ered to hold an inquest. What these ''circumstances" are which call for in- vestig^Ntion is not defined in our statutes, they being left to the coroner to deter- mine. Having made the deposition, he now can summon a jury and bold a cor- oner's court. He is empowered to call before him sucli witnesses as in his opinion can throw light upon tbe cause of death. The jury must view the body of the de- ceased, and, if the majority of the jury desire it, the coroner is directed to in- struct tbat an autopsy be performed to throw some light upon tbe cause of death. Having heard all the evidence, the coro- ner sums up, and leaves it to the jury to bring in a verdict, and, when this has been delivered, the coroner gives an order for the interment ol the body. The coroner is paid $6 for every Inqueat, and if an inquest occupies more than two days, $3 for every succeeding day. The practitioner of medicine making an ex- ternal examination of the body receives $5, making an autopsy he receives $10. There are further fixed charges for the constable who summons the jury and the witnesses, for chemical analyses, tor hire of room to be used for the inquest, and for guarding the body. THE 0081'. Taking the returns for Montreal alone, as shown by Dr. Wyatt Johnson, the cost per inquest— that is to say, per case— is decidedly greater than in London, New York or Massachusetts. The rate would seem to be $22 in Montreal, $15 in Lon- don, $16.90 in Boston, $12.80 in Massa- chusetts generally, $10 in New York ; and this notwithstanding the fact that autopsies, the most expensive individual item in the investigation of suspicious deaths, are from three to four times as frequent in the other cities as they are in Montreal. Here, in Montreal, 't costs more to maintain a dead body in the care of the coroner than it does to main- tain an ordinary live individual with healthy appetite at a first-class hotel for the same period. Some of the items per- mitted by law in the coroner's accounts ought to be lessened or removed alto- gether, others ought to pass into general police accounts. But the fact remains that the system is as expensive as its re- sults are unsatisfactory, and that the chief source of expense is the legal in- vestigation of cases which do not call for legal investigation at all, owing to the fact of death not having been due to violence. The exclusion of cases not calling for inquest by means of a prelim- inary medical examination seems to be the most rational means of reducing the expenses. Your committee is of opinion that, as a matter of principle, the payment of ttie coroner according to the number of in- quests held by him is most unsatisfac- torv, and is inimical to the proper carry- ing out of enquiries into the cause of death. FIXED SALARIES INSTEAD OF FEES. Your committee find that of the cases of death calling for a coroner's investigation occurring iv the various large towns, from oO per cent to 75 per cent, can upon pre« liminary investigation be found to bedue to natural causes. That is to say, the more careful the preliminary investiga- tion made bv the coroner, and tlie more conscientious and expert, he shows him- self in the performance of bis duties, the fewer the inquests ae finds it necessary to hold, and the leas bis income if he be paid so much per inquest. While if it so happens that his en> ?[uirie8 lead him to suspect the requent occurrence of any one form of crime at any period, as, for example, child murder, and so to bold an increased number of inquests upon certain classes of cases, immediately be lays himself open to the charge of seeking to increase his income. This ought not to be. In the cities, at least, the coroners ought to receive fixed salaries. Under the present system, the jury in Montreal, with rare exceptions, certainly cannot be said to be a capable and repre- sentative assembly of citizens. Men en- gaged actively in any form of business prefer to employ any subterfuge rather than sit for what may be many hours in a morbid atmosphero, for no return what- soever save discomfort and loss of time. The consequence is that too often the jury is composed of a heterogeneous col- lection of incapables, gathered from the highways and byeways and bar-rooms of the neighborhood. Tae verdict of such incapables is, time after time, at variance with the evidence presented. VIEWING THE BODY. The custom of viewing the body is as old as the coroner system. It arose at a time when violent deaths were as many as doctors were few, and when popula- tion was everywhere so sparse that the jury had an important part to play in de- termining by external examination that death was due to violence, and, again, in identifying the corpse. Now-a-days, in a large town, it is highly probable' that not one of the jury will have known the deceased, and the determination of the cause of death may more safely be left to medical men. In any case, it is easy to obtain identification by means other than the irruption of a strange, unseemly rabble into the house of mourning. The Iteneral feeling tbroughont the commun- ity 19 that this intrnsion into the circle of bereaved relatives in the very deptb of their trouble, permitted by the present law, ought to be preveuted. and your committee urges strongly that it ia as un necessary as It is unbecoming. It has been superseded in many states by a system of sworn adidavitot the fact of death and the identity of tbe body, and this course bbould be followed here. Tbe existing law does not demand in- quest in cases ol felo de ne. This your committee, on the whole, is inclined to consider a disadvantage. The general opinion of the community is strongly opposed to suicide, and were it to be re- cognized that this mode of death neces- sarily involved a public investigation, there is little doubt that the n-iplnas^nt publicity of the subsequent proceedings would act as a deterrent in not a few cases. As a matter of fact, snicide is on the increase in those states where this deterrent does not exist or has of late years been removed. MEDICAL EVIDENCE. A study of the verdicts brought by the coroners' juries 'shows clearly that the decision of points of medical evidence is a matter that should not be lelt to non- medical persons. Statements utterly at variance with the cause of death as- signed have been time after time ac- cepted blindly by coroner and jury. The appreciation of medical facts, and tbe opinions to be formed from these facts, come properly within the domain of the medical expert. It cannot be expected that the legal coroner and the jury should without fail form correct opinions upon delicate medical problems. Your committee strongly approves of the plan adopted in many of the United Btates, of admitting a written medical deposition of fact or opinion as evdence at Inquests in cases where tbe personal attendance of a medical witness is not considered necessary by the coroner. THE PERFORMANCE OK AlITOPBIKS. In all the large class of cases now in- vestigated before iu»"i3S where sudden death occurs without the slightest ex- ternal lesion, an autopsy is advisable. I^evertbeless, with an exception to be presently noted, no autopsy can be per- formed unless it be demanded by the majority of the jury. That is to aay, the jury has to express itself willing to waste an hour or more in tbe middle of its proceedings, ko that a competent medical man may be called, who shall make sn examination into the state of the viscera. As a consequence, the jury, in the first place, shows the greatest unwilhngness to allow the performance of autopsies, and will tbe rather return a wholly un- reliable verdict In tbe second place, the medical man performing the post mortem is at a great disadvantage, for he is expected to keep the jury wait- ing as little as possible, and his examin- ation, instead of being deliberate and careful, is hasty and liable to be imper- fect. Your committee feel assured that were the coroner allowed full power him- self to order an autopsy in all doubtful cases a very large proportion of cases would be discovered in which there would be no necessity tor holding an in- quest and summoning a jury. Thereby a very large expenditure would be pre- vented, and at the same time the cause of death would be satisfactorily estab- lished. The exception referred to above is that by tbe present law the coroner is permitted to order an autopsy if he makes an affidavit that he holds the autopry to be necessary. Unfortunately, coroners do not seem to have taken ad- vantage of tbis permission, but prefer to shelter themselves by leaving the matter wholly in the hands of the jury. PRELIMINARY INVESTIGATIONS. In all cases of suspicious death the first question to be settleo is what has been the immediate cauoe of death. In all cases, therefore, the first point to be investigated is purely medical. It is true that frequently tbe question is one that can be answered by any individual en- dowed with common sense, as, for in- stance, when- a corpse is discovered upon the railroad track minus its head, though even in such cases serious mistakes have occurred through the bodies of murdered persons beins so placed as to give an im- pression of accidental death. But if the question in certain simple cases can be answered by a layman as well as by a "• 'i.O**-*!} I professional man, there is a very large numbt'r of casen, and these often the most important frooi a inedico- legal aspect, where j» oorrert deter- mination can only be reached by a we'l- (lualiQed medical man, and where it is all important that a correct answer be sained at the outset, not only for the benelit of the relations of the deceased (thnttheybe sheltered from the least breath of unner-essary suspicion), bnt al- so for the benelit of the provincial exche- qoer, that the province be not saddled with the cost of an in(iuest leading to no result. When more than 50 per cent, of all deaths which coroners are called up- on to investigate are found to be from natural causes, it is evident that the ma- jority of deaths now investitrated require no legal investigation whatever, while.on the other hand, as indicated above, all such deaths demand an initial investiga- tion by a mediciil man. GRIMINAI. CABB8. Under the existing law, when his jury brings in a verdict of murder or man- slaughter, or of being accessory to mur- der before the fact, against any person or persons, the coroner must issue a warrant against such person or persons, and send him or them before a magis- trate or justice, if this has not already been done. He must at tb( same time transmit the depositions taken before him in the matter. To all in'ents and purposes, the trial before the magistrate proceeds as though no previous encjuiry had heen held. The coroner's depo- sitions are not employed as evidence. In fact, the magistrate treats the case as though he were proceeding under an ordinary warrant. If the magistrate confirms the charge, the case is sent up to the grand jury, and here auiain all the witneRses are once more summoned and the evidence is repeated, and the grand jury finding a true bill, the case goes be- fore tbA petit jury, and again the evi- dence is repeated. It appears to your committee that this proceedintr is singularly cumbrous, and that, besides harassing the witnesses, it allows an unduly large number ot loop- boles of escape for those guilty, upon some legal technicality or faulty observ- ance of le^al procedure. Your commit- tee, considering that thu problem of bow tins procedure may be simplified is a pi. rely legal one, does not offer any sug- gestions on the matter. Taking all these disadvantages into consideration, and being especially im- pressed by the fact that the earliest stages in the investigation of suspicious death must of necessity be of a medical nature, and by the further f ct that where the logal proceedings of the coro- ner lead to a definite cliarue again.st an individual or individuals, those legal proceedings are practically passed over unnoticed by the higher courts, your committee have come to the conclusion that a drastic change in the mode of in- vestigation of suspicious deaths is advis- able in this province. TlIK COItONEU's I'KKSONAMTY. There are two questions which natural- ly suggest themselves prominently in connection with questions of coroners' re- form. The first is, Should the coroner be a physician or a lawyer? and the second. Should the office of coroner be abolished? With regard to the qualifications neces- sary for coroners, your committee does not thinlc it necessary to dwell upon the relative advantages ot having medical or legal coroners, although this is a subject ot dispute which has now been fruitlessly discussed for more than a century, and will ia all likelihood continue to be so as long as the coroner system lasts. In London a settlement of the question has been attempted by selecting as far as possible coroners who have obtained both legal and medical qualifications. This plan of expecting the coroner to be a jack-of-all-trades has not much to recom- mend it ; and the fact that in London, in addition to the doubly qualified coroner, there are the deputy coroners, who are obliged by law to be barristers, and all the medical expert work is done by out- side men, sliows that matters are not in any way simplified even by having the coroners who are at once both lawyers and physicians. The only rational plan, and one whose advantages appear never to have been questioned, is that adopted on the conti- MHMM mfKHf. ■m nent, as well ob in those states which are now under the medical examiners sys- tem, of separating aa far as possible the medical and legal side of the investiga- tion, and entrusting ttieae to physicians and lawyers respectively. Your commit- tee is just as iirmly <. evinced that all legal questions should be left wholly to lawyers, as that all medical ones should be entrusted to medical men. ABOLITION OF THE OFKICK OF COUONEK. Your committee finds that in those states where this has been done, the pre- vious difTiculties seem to have been promptly and permanently removed, and it dees not appear to have been necessary in any instance to revive the office. The office of coroner was created in England while that country was in a lawless state, atid when police regula- tions and courts of justice were almost non«existent. Since the development of the judicial and police system, the coroner's office has gradually come to fill the important function of fifth wheel to the car of justice. It has been retained through that conservative spirit which retains the cumbrous system of pounds, shillings and penct. for the national cur- rency. Many* of the United States are still in that primitive and lawless condi- tion, which makes the office of coroner a useful one. In the more highly civilized states the old coroner system is rapidly disappearing, and it is practically obso- lete in five, viz.: Massachusetts, Rhode Island, Connecticut, New Jersey and Ne\v Hampshire. As to whether the office of coroner should be abolished in our own province, we have no hesitation in stating, as med- ical men, that, from a medical point of view, the office is simply an absurdity, which constantly interferes with the pro- per employment of medical science for judicial ends, and that it could be abol- izbod to-morrow with marked benefit to the medi'^al side of criminal cases. The fact tLAt the appointment of com- fietent medical experts as consultants to he coroner's court of Montreal during the )ast year has neither prevented nor to be absolutely to secure the reforms. All that is to do away greatly diminished the number of those palpably absurd and unsatisfactory ver- dicts, which have made this court a public laughing-stock in past years, shows that something must be radically wrong with the system, which must be re- medied, even if tfiis necessitates abolish- ing the oflice. On the other hand, we do not feel, as medical men, competent to decide as to the possitle offects which would be pro- duced by this .-^hange from a judicial point of yiew. li ♦he office of coroner were abolished, the legal duties would have to be provided for '.r^ some way, the details of which can only be decided by persons thoroughly conversant with the workings of our criminal law. Further- more, the abolition of the office of coroner does not appear to your committee necessary in order necessary medical is really neceseary with the medical functions and responsibilities of the cor- oner and to make the office a purely ju- dicial one, only dealing with those cases where there are definite grounds to sus- pect death from violence or negligence and these grounds are either strengthened or net removed by the examination of a medical expert. A COMPROMISE IDEA. We would therefo e recommend : 1. That salaried medical examiners be appointed to investigate all deaths occur- ring under circumstances calling for medico-legal investi.^ation under any act, and that these officers be given authority to make such medical examination of the body as may be necessary to deter- mine whether death was due to violence or not ; 2. That in every case the medical ex- aminers report the result of their exam- ination to the coroner or other judicial ofiicer charged with investigating the legal side of such cases, who, in case of violent death, shall make such investiga- tions and take such measures as are ne- cessary for the proper administration of the law. VI : -'H'»"«.."»>«ij ■^■P"